The effect of contextual factors on unintentional injury hospitalization: from the Korea National Hospital Discharge Survey

Abstract

BackgroundIt has been suggested that health risks are affected by geographical area, but there are few studies on contextual effects using multilevel analysis, especially regarding unintentional injury. This study investigated trends in unintentional injury hospitalization rates over the past decade in Korea, and also examined community-level risk factors while controlling for individual-level factors.MethodsUsing data from the 2004 to 2013 Korea National Hospital Discharge Survey (KNHDS), trends in age-adjusted injury hospitalization rate were conducted using the Joinpoint Regression Program. Based on the 2013 KNHDS, we collected community-level factors by linking various data sources and selected dominant factors related to injury hospitalization through a stepwise method. Multilevel analysis was performed to assess the community-level factors while controlling for individual-level factors.ResultsIn 2004, the age-adjusted unintentional injury hospitalization rate was 1570.1 per 100,000 population and increased to 1887.1 per 100,000 population in 2013. The average annual percent change in rate of hospitalizations due to unintentional injury was 2.31% (95% confidence interval: 1.8–2.9). It was somewhat higher for females than for males (3.25% vs. 1.64%, respectively). Both community- and individual-level factors were found to significantly influence unintentional injury hospitalization risk. As community-level risk factors, finance utilization capacity of the local government and neighborhood socioeconomic status, were independently associated with unintentional injury hospitalization after controlling for individual-level factors, and accounted for 19.9% of community-level variation in unintentional injury hospitalization.ConclusionRegional differences must be considered when creating policies and interventions. Further studies are required to evaluate specific factors related to injury mechanism.

Data resource profile: the Korea National Hospital Discharge In-depth Injury Survey

“…With over 100 publications as of July 2020, the KNHDIS has been used to answer a variety of relevant research questions. The main research issues it addresses include the effect of disease burden [16][17][18] and risk factors on hospitalization duration [18][19][20][21], epidemiologic characteristic of injuries [22][23][24][25], and so on. A full list of publications involving the KNHDIS data in domestic and international journals is available from the supplementary data section at IJE online.…”

Sociodemographic distribution and correlates of nonfatal unintentional non‐traffic‐related injuries in Kenya: Results from the 2014 demographic and health survey

“…Lastly, host factors such as an individual's mental health, level of physical activity; contextual environmental factors such as occupational hazards and safety profiles and community level risk factors for each injury mechanism could not be examined in the present study due to constraints of the scope of the data sets. Such factors have been previously shown to influence UIIs from a broader agent‐host‐environment epidemiological view point 41 …”

“…Such factors have been previously shown to influence UIIs from a broader agent‐host‐environment epidemiological view point. 41 …”

Medical Emergencies Requiring First Aid at Home: A Population-Based Survey Study

“…To our knowledge, this is the first study to estimate the victims' approach to health-care facilities after medical emergency. 20,21 The burden was again confirmed by high hospital admission rates.…”

“…Providing first aid for seizures appears to be a global challenge. O' Hara et al documented low first aid provision during seizures in a group of school nurses, EMS personnel, and teachers 20.…”