Activity Limitation, Health-Care Use, and Unmet Need Among Korean Adults: Cumulative and Conditional Cardiometabolic Care Cascades.
- 1Healthcare Service School, Soonchunhyang University, 22 Soonchunhyang-ro, Asan-si 31538, Republic of Korea.
Abstract
Background
Adults with activity limitation carry a heavier cardiometabolic burden, but whether differences arise in disease detection or subsequent management remains unclear. Cascade studies rarely measure health-care use directly and compute each stage against all prevalent cases-a cumulative formulation that cannot separate detection from later transitions. I assessed utilization, screening, unmet need, and conditional cascade attainment together.Methods
I analyzed the ninth Korea National Health and Nutrition Examination Survey cycle (2022-2024), a nationally representative cross-sectional survey (16,672 adults aged ≥19 years; cardiometabolic and cascade analyses were restricted to adults aged ≥30, and cancer screening to adults aged ≥40). I estimated prevalence ratios (PRs) using survey-weighted Poisson regression, adjusted for age, sex, education, income, smoking, and drinking, with Benjamini-Hochberg false-discovery control across 17 comparisons. I defined cascade stages conditionally and, secondarily, cumulatively.Results
Activity limitation (11.0%) was associated with higher prevalence of hypertension (PR 1.10, 95% confidence interval [CI]1.04-1.17) and diabetes (PR 1.23, 95% CI 1.11-1.37). Outpatient (1.75, 1.63-1.88) and inpatient (2.20, 1.95-2.48) utilization were higher, whereas general health (0.99, 0.95-1.02) and cancer (0.99, 0.95-1.03) screening were not. Unmet need was 19.0% versus 7.7% (2.39, 2.10-2.71). Awareness was higher (1.06-1.14), but no statistically detectable differences were observed in conditional treatment (0.98-1.01) or control (0.98-1.17). Cumulative point estimates for treatment were higher (1.06-1.11), retaining the awareness difference.Conclusions
Higher utilization did not correspond to greater screening or lower unmet need, and higher awareness was not accompanied by statistically detectable advantages in treatment or control. Cumulative and conditional cascades answer different questions; reporting both locates where a management difference arises.
Related
- Differential associations of baseline, dynamic change, and cumulative average TyG-BMI with incident cardiometabolic multimorbidity: a longitudinal landmark analysis of CHARLS
- Associations of cumulative exposure and dynamic trajectories of the combined atherogenic-frailty index with incident cardiometabolic multimorbidity: a prospective cohort study.
- Cumulative-incidence crossover and conditional mortality after definitive surgery for endometrial cancer: a population-based competing-risk analysis
- Associations of cumulative exposure and dynamic trajectories of the combined estimated glucose disposal rate and frailty index with incident cardiometabolic multimorbidity comprising diabetes, heart disease, and stroke: a longitudinal analysis based on the China health and retirement longitudinal study (CHARLS)
- Role of Physical Activity in Obesity Treatment and Cardiometabolic Health: A Scientific Statement From the American Heart Association
BibTeX
@article{kim2026activity,
title = {{Activity Limitation, Health-Care Use, and Unmet Need Among Korean Adults: Cumulative and Conditional Cardiometabolic Care Cascades.}},
author = {Joungmin Kim},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/healthcare14193198},
url = {https://europepmc.org/article/MED/42881636},
note = {CC BY},
}
RIS
TY - JOUR
TI - Activity Limitation, Health-Care Use, and Unmet Need Among Korean Adults: Cumulative and Conditional Cardiometabolic Care Cascades.
AU - Joungmin Kim
PY - 2026
DA - 2026/09/28
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193198
UR - https://europepmc.org/article/MED/42881636
AB - Background Adults with activity limitation carry a heavier cardiometabolic burden, but whether differences arise in disease detection or subsequent management remains unclear. Cascade studies rarely measure health-care use directly and compute each stage against all prevalent cases-a cumulative formulation that cannot separate detection from later transitions. I assessed utilization, screening, unmet need, and conditional cascade attainment together.Methods I analyzed the ninth Korea National Health and Nutrition Examination Survey cycle (2022-2024), a nationally representative cross-sectional survey (16,672 adults aged ≥19 years; cardiometabolic and cascade analyses were restricted to adults aged ≥30, and cancer screening to adults aged ≥40). I estimated prevalence ratios (PRs) using survey-weighted Poisson regression, adjusted for age, sex, education, income, smoking, and drinking, with Benjamini-Hochberg false-discovery control across 17 comparisons. I defined cascade stages conditionally and, secondarily, cumulatively.Results Activity limitation (11.0%) was associated with higher prevalence of hypertension (PR 1.10, 95% confidence interval [CI]1.04-1.17) and diabetes (PR 1.23, 95% CI 1.11-1.37). Outpatient (1.75, 1.63-1.88) and inpatient (2.20, 1.95-2.48) utilization were higher, whereas general health (0.99, 0.95-1.02) and cancer (0.99, 0.95-1.03) screening were not. Unmet need was 19.0% versus 7.7% (2.39, 2.10-2.71). Awareness was higher (1.06-1.14), but no statistically detectable differences were observed in conditional treatment (0.98-1.01) or control (0.98-1.17). Cumulative point estimates for treatment were higher (1.06-1.11), retaining the awareness difference.Conclusions Higher utilization did not correspond to greater screening or lower unmet need, and higher awareness was not accompanied by statistically detectable advantages in treatment or control. Cumulative and conditional cascades answer different questions; reporting both locates where a management difference arises.
SN - 2227-9032
ER -