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J Korean Soc Hypertens. 2014 Mar;20(1):8-20. Korean.
Published online March 31, 2014.  https://doi.org/10.5646/jksh.2014.20.1.8
Copyright © 2014. The Korean Society of Hypertension
Analysis for the Patterns of Medical Care Utilization during 19 Years (1990-2008) and Its Related Factors in Hypertensive Patients Using National Patient Survey in Korea
Nam Wook Hur, PhD, and Hyeon Chang Kim, PhD
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author (Email: namwookhur@gmail.com )
Received February 10, 2014; Revised March 04, 2014; Accepted March 10, 2014.

Abstract

Background

To analyze the patterns of medical care utilization and its related factors in hypertensive patients during 19 years (1990-2008), utilizing national patient survey in Korea.

Methods

Using seven surveyed data, age-standardized medical care utilization increasing ratios for the inpatients and outpatients compared to the year of 1990 were calculated, respectively. Changes of medical facilities (%) of patients used in 1990, 1999, and 2008 were compared. For the outpatients, median length of stay and discharge mortality rate per 1,000 persons were calculated. Multivariate logistic regression methods were used to identify related factors of the resident patients and the comparison characteristics between hypertensives and the others of all subjects. Sample weights were used.

Results

The medical care utilization of hypertensives were increased for both inpatients and outpatients. However, the ratios were dramatically diminished after the standardization. Age-standardized ratios were 3.6 in outpatients and 5.9 in inpatients compared to 1990. For the outpatients, mainly used medical facilities were changed from general hospital to convalescent hospital. Also, median length of stay and discharge mortality rate were increased up to 5 times and 4 times compared to 1990. The odds of being resident patients were related with discharge as death and using oriental medical center convalescent hospital in 2008. Hypertensive patients were older than the others. Confined to hypertensive patients, member of National Health Insurance was more tend to be outpatients but less inpatients.

Conclusions

Aging population and long-term care Act were presumed as the main reason for the increasing of medical care utilization in 1990 to 2008.

Keywords: Hypertension; Utilization review; Health care surveys

Figures


 Fig. 1
Comparison the ratios for the number of medical care users as hypertensives per day compared to the year of 1990 according to the age groups and standardization. Standardization using standard population in Korean in 2005. (A-D) Outpatients data by life cycle age groups from 1990 to 2008. (E-H) Inpatients data by life cycle age groups from 1990 to 2008.
Click for larger image


Fig. 2
Comparison the ratios for the number of medical care users per day as hypertensives compared to the year of 1990 according to the gender. All the p for trends are < 0.001. Standardization using standard population in Korea in 2005. (A) Outpatients men and (B) women data from 1990 to 2008. (C) Inpatients men and (D) women data from 1990 to 2008.
Click for larger image


Fig. 3
Changes of using type of medical facilities (%) by year of 1990, 1999, and 2008. (A) Total outpatients. (B) Confined to ≥ 65 years outpatients. (C) Total Inpatients. (D) Confined to ≥ 65 years inpatients.
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Tables


 Table 1
Pre- and post-standardized number of hypertensive patients using medical care utilization per day
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Table 2
Median length of stay and mortality rate of inpatients
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Table 3
Factors for resident patients by year of 1994, 1999, and 2008
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Table 4
Major characteristics of hypertensive patients among total medical care utilization patients by year of 1990 1999, and 2008
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Notes

No potential conflict of interest relevant to this article was reported.

Appendix 1

Total subjects number of surveyed patients each year (including hypertensives)

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