Journal List > Tuberc Respir Dis > v.70(4) > 1001607

Lee, Doh, Lee, Noh, Lee, Kim, and Oh: Trends and Factors in Health Care Utilization of Patients with Chronic Obstructive Pulmonary Disease in Korea: A Nationwide Survey from 1990 through 2008

Abstract

Background

Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea.

Methods

We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included.

Results

OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both).

Conclusion

Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

Figures and Tables

Figure 1
Trends in health care utilization rate of patients with COPD during period 1990~2008. Time trends of OPD visit and hospitalization is significant. *p=0.019, p=0.001. COPD: chronic obstructive pulmonary disease; OPD: outpatient department.
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Figure 2
Age-specific trends in OPD visit rate of patients with COPD during period 1990-2008 years. *p=0.601, p=0.246, p=0.117 respectively. COPD: chronic obstructive pulmonary disease; OPD: outpatient department.
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Figure 3
Age-specific trends in hospitalization rate of patients with COPD during period 1990~2008 years. *p=0.601, p=0.459, p<0.001. COPD: chronic obstructive pulmonary disease.
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Figure 4
Disease-specific trends in OPD visit rate during period 1990~2008 years. URI: acute upper respiratory infection; INF: influenza; PNE: pneumonia; BRO: acute bronchitis or acute bronchiolitis; SIN: chronic sinusitis; COPD: chronic obstructive pulmonary disease; AST: asthma; NEC: not-elsewhere-classified respiratory diseases.
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Figure 5
Trends in OPD visit rate of patients with any respiratory diseases during period 1990~2008 years (p=0.002). OPD: outpatient department.
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Table 1
Characteristics of subjects with COPD during 1990~2008
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Values are presented as percents.

*Values are expressed as mean±SD, Other areas represent small cities and rural area, Others represent public health center and the others.

COPD: chronic obstructive pulmonary disease; SD: standard deviation.

Table 2
Risk factors for outpatient department visit in subjects with COPD
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*Logistic regression analysis was done for multivariate analysis of pooled data from 1990 through 2008, Other areas represent small cities or rural area.

COPD: chronic obstructive pulmonary disease; OR: odds ratio; CI: confidence interval.

Table 3
Risk factors for hospitalization in subjects with COPD
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*Logistic regression analysis was done for multivariate analysis of pooled data from 1990 through 2008, Other areas represent small cities or rural area.

COPD: chronic obstructive pulmonary disease; OR: odds ratio; CI: confidence interval.

Acknowledgements

This study was supported by grants of the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs (A102065), and of the Korea Institute for Health and Social Affairs.

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