The Korea National Disability Registration System (KNDRS) was established in 1989 to provide social welfare benefits based on predefined criteria for disability registration and an objective medical assessment using a disability grading system. Disability registration requires (1) a medical examination by a qualified specialist physician and (2) a medical advisory meeting to review the degree of disability. Medical institutions and specialists for the diagnosis of disabilities are legally stipulated, and medical records for a specified period are required to support the diagnosis. The number of disability types has gradually expanded, and 15 disability types have been legally defined. As of 2021, 2.645 million people were registered as disabled, accounting for approximately 5.1% of the total population. Among the 15 disability types, disabilities of the extremities account for the largest proportion (45.1%). Previous studies have investigated the epidemiology of disabilities using data from the KNDRS, combined predominantly with data from the National Health Insurance Research Database (NHIRD). Korea has a mandatory public health insurance system that covers the entire Korean population, and the National Health Insurance Services manages all eligibility information, including disability types and severity ratings. In short, the KNDRS-NHIRD is a significant data resource for research on the epidemiology of disabilities.

It is well known that cancer patients’ perception of social support is associated with their depressive symptoms and health-related quality of life. However, there have been little studies that compared the variates of cancer patients with the general population. We sought to compare differences in the level of perceived social support and the impact of perceived social support on depressive symptoms and health-related quality of life between cancer survivors and the general population. Data were collected from 1818 cancer patients treated at the National Cancer Center and regional cancer centers in South Korea. The control group of the general population was composed of 2000 individuals without cancer from community. Cancer patients reported significantly higher level of perceived social support than the general population, while they reported lower health-related quality of life and were more susceptible to depression. The positive associations of higher perceived social support with lower depressive symptoms, as well as with higher health-related quality of life, were stronger among cancer patients than among the general population. The interaction effect suggests that the impact of social support would be stronger among cancer patients than the general public. Thus, it would be beneficial to pay attention to providing social support to cancer patients, particularly to those who are more vulnerable. Furthermore, investigation of the most effective and efficient methods to deliver social support interventions would be worthwhile.

Park JE, et al. J Korean Med Sci. 2024 Nov;39:e328. https://doi.org/10.3346/jkms.2024.39.e328

Background: Health disparities among individuals with disabilities remain underrecognized. The objective of the current study was to investigate: 1) whether disparities exist in breast cancer screening rates among women with disabilities compared with women without disabilities; 2) whether breast cancer screening rates vary according to the type and severity of disabilities; and 3) trends in breast cancer screening disparities according to disability status over time.Methods: Using national administrative databases concerning disability status and national cancer screening programs in Korea, age‐standardized participation rates were calculated according to the type and severity of disabilities.Results: The age‐standardized rate for breast cancer screening in individuals with disabilities increased from 30.2% in 2006 to 53.7% in 2015 (change of +23.5%), whereas that among those without a disability increased from 29.3% to 60.1% (change of +30.8%). In general, disability was associated with slightly lower breast cancer screening rates (adjusted odds ratio [aOR], 0.824; 95% CI, 0.820‐0.828). However, screening rates were especially low in women with severe disabilities (aOR, 0.465; 95% CI, 0.461‐0.469) and among women with autism (aOR, 0.235; 95% CI, 0.143‐0.388), renal failure (aOR, 0.342; 95% CI, 0.337‐0.348), brain injury (aOR, 0.349; 95% CI, 0.346‐0.352), intellectual disabilities (aOR, 0.403; 95% CI, 0.397‐0.410), mental disorders (aOR, 0.494; 95% CI, 0.488‐0.501), or ostomies (aOR, 0.529; 95% CI, 0.512‐0.546).Conclusions: Even without a cost barrier, significant disparities were found in breast cancer screening participation, especially in women with severe disabilities and brain‐related and/or mental disabilities. Policy efforts, such as ensuring the accessibility of information and equipment, transportation support, and access to a usual source of care, should be made to decrease this disparity.