Health Policy Manag.  2020 Mar;30(1):62-71. 10.4332/KJHPA.2020.30.1.62.

Factors Affecting the Healthcare Utilization of Spinal and Joint Surgery in Elderly Patients

• Jeong SH
• Gu YJ
• Yoo KB

• KMID: 2507286
• DOI: http://doi.org/10.4332/KJHPA.2020.30.1.62

Abstract

Background
The purpose of this study is to analyze the current status and factors of elderly patients’ hospitalization for hip replacement, knee replacement, and general spine surgery.
Methods
National health insurance data in 2018 was provided by the National Health Insurance Service. We used multiple regression to analyze factors associated with the medical utilization of hip replacement, knee replacement, and general spine surgery in elderly patients over 65 years old. The dependent variables are the length of stay and total health expenditure. The independent variables are the demographic-social factors (sex, age, region, insurance type, income level) and surgery-related factors (institution type, location of the hospital, surgery classification).
Results
The most common factor affecting surgery was the location of medical institutions. Compared with the medical institutions located in metropolitan, the length of stay in rural medical institutions was higher and total health expenditure was lower. The lower quartile of income, the higher the length of stay and total health expenditure. In addition, the variables of age, type of health insurance, and type of medical institution were statistically significant.
Conclusion
In this study, we confirmed the effect of sociodemographic factors and medical institution factors on the Healthcare Utilization of spinal and joint surgery.

Keyword

Aged; Hip replacement; Knee replacement; General spine surgery; Healthcare utilization