학술논문
취약계층 결핵 환자의 치료 성공 관련 요인
Factors Related to Successful Tuberculosis Treatment in Vulnerable Groups
Factors Related to Successful Tuberculosis Treatment in Vulnerable Groups
Document Type
Article
Author
김영현 / Younghyun Kim; 이지연 / Ji Yeon Lee; 정인아 / Ina Jeong; 김정현 / Junghyun Kim; 김주혜 / Joohae Kim; 한지연 / Jiyeon Han; 정은진 / Eunjin Jeong; 한아연 / Ah Yeon Han; 조준성 / Joon-sung Joh; 박정덕 / Jung-duck Park
Source
대한내과학회지 (Korean J Med) / The Korean Journal of Medicine (Korean J Med). Feb 01, 2022 97(1):50
Subject
Language
Korean
ISSN
1738-9364
Abstract
목적: 우리나라 결핵의 발생률과 사망률은 감소하고 있는 추세이나 취약계층 결핵 환자 치료비 지원자 수는 2017년에 비해 2019년에 3.8배 증가하였다(결핵안심벨트 지원사업, 2019). 이 연구의 목적은 취약계층 결핵 환자의 치료 성공 여부에 영향을 미치는 요인을 규명해 보는 것이다. 방법: 취약계층 결핵 환자 지원사업인 결핵안심벨트 사업에서 치료비 지원을 받은 환자의 2014-2018년 자료를 분석하였다. 연구 분석 대상자는 137명이고 독립변수는 환자의 개인요인(연령, 성별, 국적, 결핵 종류, 내성결핵 여부, 동반 질환 수, 주거 형태)과 치료 형태요인(외래, 입원)이며 종속변수는 치료 성공 여부이다. 결과: 동반 질환 수는 없음보다 동반 질환 1개(OR 0.202), 2개(OR 0.147), 3개 이상(OR 0.070)일 때 모두 치료 성공 가능성이 낮아지고 통계적으로 유의한 것으로 나타났으며, 주거 형태는 동거(시설, 일터, 지인 집)를 기준으로 독거(OR 0.097)와 노숙(OR 0.053)이 치료 성공 가능성이 낮아지고 통계적으로 유의하게 나타났다. 국적은 외국인에 비해 내국인(OR 8.512)이 치료 성공 가능성이 높아지고 통계적으로 유의하게 나타났다. 결론: 동반 질환이 있는 취약계층 결핵 환자의 관리가 강조되어야 할 것으로 판단되고, 주거 형태가 불안정한 독거생활을 하는 결핵 환자나 노숙인 결핵 환자의 경우 결핵 환자시설로의 입소를 지원하기 위한 지역사회기반의 마련 및 외국인 거주자에 대한 대처방안이 취약계층 결핵 환자의 효율적인 관리를 위해 필요하다고 판단된다.
Background/Aims: Although the incidence and mortality of tuberculosis are decreasing in South Korea, the number of applications for financial assistance with the cost of tuberculosis treatment made by individuals from vulnerable groups was 3.8 times higher in 2019 compared to 2017 (Tuberculosis Relief Belt Project, 2019). Methods: We analyzed the data of patients who received financial aid for tuberculosis treatment (in the period 2014-2018) from the Tuberculosis Relief Belt Project, which was designed to assist vulnerable groups. This study analyzed 137 subjects, and the independent variables included patient factors (age, gender, nationality, tuberculosis type, number of comorbidities, and place of residence) and treatment type (outpatient or inpatient). The dependent variable was the treatment outcome. Results: The likelihood of treatment success was significantly lower for patients with one (odds ratio [OR] 0.202), two (OR 0.147), or three or more (OR 0.070) comorbidities compared to those with no comorbidities. This was also the case for patients living alone (OR 0.097), and for those classified as homeless (OR 0.053). Korean patients (OR 8.512) had a significantly higher probability of a successful treatment outcome than foreigners. Conclusions: Appropriate community-based management of individuals with tuberculosis from vulnerable groups, including foreigners, people with comorbidities, people living alone, and people with an unstable residential situation or homeless status, is important. (Korean J Med 2022;97:50-59)
Background/Aims: Although the incidence and mortality of tuberculosis are decreasing in South Korea, the number of applications for financial assistance with the cost of tuberculosis treatment made by individuals from vulnerable groups was 3.8 times higher in 2019 compared to 2017 (Tuberculosis Relief Belt Project, 2019). Methods: We analyzed the data of patients who received financial aid for tuberculosis treatment (in the period 2014-2018) from the Tuberculosis Relief Belt Project, which was designed to assist vulnerable groups. This study analyzed 137 subjects, and the independent variables included patient factors (age, gender, nationality, tuberculosis type, number of comorbidities, and place of residence) and treatment type (outpatient or inpatient). The dependent variable was the treatment outcome. Results: The likelihood of treatment success was significantly lower for patients with one (odds ratio [OR] 0.202), two (OR 0.147), or three or more (OR 0.070) comorbidities compared to those with no comorbidities. This was also the case for patients living alone (OR 0.097), and for those classified as homeless (OR 0.053). Korean patients (OR 8.512) had a significantly higher probability of a successful treatment outcome than foreigners. Conclusions: Appropriate community-based management of individuals with tuberculosis from vulnerable groups, including foreigners, people with comorbidities, people living alone, and people with an unstable residential situation or homeless status, is important. (Korean J Med 2022;97:50-59)