Tuberc Respir Dis.  2011 Apr;70(4):307-314.

Trends and Factors in Health Care Utilization of Patients with Chronic Obstructive Pulmonary Disease in Korea: A Nationwide Survey from 1990 through 2008

• Lee GD
• Doh SR
• Lee JS
• Noh CS
• Lee SD
• Kim DS
• Oh YM

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.

Keyword

Pulmonary Disease, Chronic Obstructive; Risk Factors; Health Care Surveys; Community Health Services

MeSH Terms

Aged
Cause of Death
Community Health Services
Delivery of Health Care
Health Care Surveys
Health Services
Hospitalization
Humans
Korea
Male
Outpatients
Physicians' Offices
Pulmonary Disease, Chronic Obstructive
Retrospective Studies
Risk Factors

Figure

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  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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