Korean J Intern Med.  2021 Sep;36(5):1146-1156. 10.3904/kjim.2020.168.

Patterns of medical care utilization according to environmental factors in asthma and chronic obstructive pulmonary disease patients

• Jo EJ
• Choi MH
• Kim CH
• Won KM
• Kim YK
• Jeong JH
• An HY
• Hwang MK
• Park HK

• KMID: 2519791
• DOI: http://doi.org/10.3904/kjim.2020.168

Abstract

Background/Aims
Weather and air pollution are associated with the exacerbation of respiratory diseases. We investigated patterns of medical care use according to meteorological factors and air pollution in patients with asthma or chronic obstructive pulmonary disease (COPD).
Methods
We analyzed the medical care utilization patterns of patients with asthma or COPD registered in the Korea Health Insurance Review and Assessment database for the period 2007 to 2013. The patterns were divided into hospitalization and emergency department (ED) use.
Results
The medical care use of patients with asthma or COPD increased when the mean temperature and relative humidity were lower, and the temperature difference and atmospheric pressure were greater. Medical care use increased with the concentrations of particulate matter and ozone. Among age groups, sensitivity to pollutants was greatest in patients aged ≥ 65 years. The effect of being elderly was greater for asthma than for COPD, with a higher hospitalization rate. ED utilization affected by environmental factors was significantly greater for females and hospitalization was significantly more common for males.
Conclusions
Meteorological factors and air pollutants were shown to contribute to increased medical care utilization by patients with asthma and COPD, particularly elderly patients. The overall effect was greater for COPD, but the effect in elderly patients was greater for asthma. In addition, the patterns of change in medical care use due to environmental factors differed according to sex.

Keyword

Weather; Air pollution; Asthma; Pulmonary disease; chronic obstructive; Health care utilization