Discordance Between Self-Rated Health and Metabolic Syndrome Risk in Healthcare Utilization

Background

Discordance between self-rated health and objective metabolic risk may lead to misperceived health needs and suboptimal healthcare utilization. This study examined the association between discordance in self-rated health and metabolic syndrome status and healthcare utilization.

Methods

This study included 13,625 adults without a history of medically serious disease from the 2022–2024 Korea National Health and Nutrition Examination Survey. Participants were classified into four groups according to self-rated health and metabolic syndrome status: “concordant–good”, “underestimation”, “overestimation”, and “concordant–poor.” Overestimation was defined as favorable self-rated health despite unfavorable metabolic syndrome status, whereas underestimation was defined as unfavorable self-rated health despite favorable metabolic syndrome status. Associations between these groups and healthcare utilization outcomes were evaluated using survey-weighted multivariable logistic regression, with the concordant–good group as the reference.

Results

Compared with the concordant–good group, distinct patterns of healthcare utilization were observed. Individuals in the overestimation group had higher odds of non-participation in health screenings (aOR=1.15, 95% CI: 1.02–1.29) but were less likely to report non-receipt of influenza vaccination (aOR=0.86, 95% CI: 0.76–0.96). Unmet healthcare needs were higher among those in the underestimation group (aOR=2.36, 95% CI: 1.93–2.87) and the concordant–poor group (aOR=2.09, 95% CI: 1.67–2.63).

Conclusions

Overestimation may reflect limited awareness of health risks and lower participation in discretionary preventive behaviors, such as health screening, whereas underestimation may reflect heightened perceived needs and greater unmet healthcare needs. These findings highlight the importance of targeted interventions to improve risk awareness and align perceived health status with objective metabolic risk.

Key messages

• Individuals with discordance between self-rated health and metabolic risk may underutilize preventive healthcare services.

• Addressing misperception of health status could improve health screening uptake and reduce unmet healthcare needs.