The health care burden of high grade chronic obstructive pulmonary disease in Korea: analysis of the Korean Health Insurance Review and Assessment Service data.
The health care burden of high grade chronic obstructive pulmonary disease in Korea: analysis of the Korean Health Insurance Review and Assessment Service data.
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DOI：
10.2147/copd.s48577
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发表时间：
2013
影响因子：
2.8
通讯作者：
Yoon H
中科院分区：
文献类型：
--
作者：
Kim J;Rhee CK;Yoo KH;Kim YS;Lee SW;Park YB;Lee JH;Oh Y;Lee SD;Kim Y;Kim K;Yoon H
重度慢性阻塞性肺疾病(COPD)患者占COPD相关死亡的很大一部分，并造成过高的经济负担和医疗服务利用。我们的目标是利用2009年韩国健康保险审查和评估服务的全国数据来确定这类患者的特征和医疗保健用途。COPD患者是通过搜索国际疾病分类-第10版使用药物的患者来识别的。重度COPD患者是根据他们去三级医院就诊和用药的模式来选择的。在研究期间，韩国重度COPD患者的数量迅速增加，他们表现出很高的并存疾病患病率。重度慢性阻塞性肺疾病患者的总医疗费用是非患者的三倍多(3,744美元对1,183美元；P<；0.001)。药物费用占医疗费用的比例最大，但两组患者的住院和病情恶化的影响最大。COPD分级和上一年住院天数是影响医疗费用和卫生资源利用天数的主要因素。在韩国，重度COPD患者给医疗保健系统带来了沉重的经济负担。无论在临床上还是在经济上，防止进展到高级别COPD都很重要。
Patients with high grade chronic pulmonary obstructive disease (COPD) account for much of the COPD-related mortality and incur excessive financial burdens and medical care utilization. We aimed to determine the characteristics and medical care use of such patients using nationwide data from the Korean Health Insurance Review and Assessment Service in 2009. Patients with COPD were identified by searching with the International Classification of Diseases–10th Revision for those using medication. Patients with high grade COPD were selected based on their patterns of tertiary institute visits and medication use. The numbers of patients with high grade COPD increased rapidly in Korea during the study period, and they showed a high prevalence of comorbid disease. The total medical costs were over three times higher in patients with high grade COPD compared with those without it ($3,744 versus $1,183; P < 0.001). Medication costs comprised the largest portion of medical cost, but most impact came from hospitalization and exacerbation in both groups of patients. COPD grade and hospitalization in the previous year were the major factors affecting medical costs and days of utilizing health care resources. Patients with high grade COPD impose a high economic burden on the health care system in Korea. Prevention of progression to high grade COPD is important, both clinically and economically.