Yonsei Med J.
2022 Oct;63(10):948-955. 10.3349/ymj.2022.0110.
National Trends in Hospitalization for Ambulatory Care Sensitive Conditions among Korean Adults between 2008 and 2019
- Affiliations
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- 1HIRA Research Institute, Health Insurance Review and Assessment Service, Wonju, Korea
- 2Department of Public Health, Yonsei University College of Medicine, Seoul, Korea
- 3Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Korea
- 4Department of Health Administration, Yonsei University Graduate School, Wonju, Korea
- 5Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- 6Public Healthcare Center, Seoul National University Hospital, Seoul, Korea
- 7Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- KMID: 2533396
- DOI: http://doi.org/10.3349/ymj.2022.0110
Abstract
- Purpose
This study aimed to examine 12-year trends in hospitalization rates for ambulatory care sensitive conditions (ACSC) and factors affecting hospitalization.
Materials and Methods
This study used data on Korean National Health Insurance and Medical Aid patients aged 19 and over who used medical services at least once between January 2008 and December 2019 with an ACSC as their major diagnosis. As of 2019, a total of 12324071 patients were included. To check for any changes in hospitalization, age- and sex-standardized hospitalization rates were obtained for each condition and insurance type, and multiple logistic regression was performed to identify factors affecting hospitalization.
Results
The collective average ACSC hospitalization rate decreased from 5.0% in 2008 to 4.2% in 2019. Specifically, hospitalization rates for hypertension (1.4% in 2008; 0.8% in 2019), diabetes (5.8% in 2008; 3.3% in 2019), and chronic obstructive pulmonary disease and asthma (4.1% in 2008; 3.2% in 2019) decreased, while rates for pneumonia (24.5% in 2008; 28.1% in 2019) and urinary tract infection (UTI) (5.7% in 2008; 6.4% in 2019) increased. The rate for heart failure decreased 2.3% between 2008 and 2012 and then rebounded. The odds of hospitalization among Medical Aid patients were 1.45–4.20 times higher than those of National Health Insurance patients.
Conclusion
Differences in trends were confirmed for ACSC hospitalization rates among different conditions and insurance types in Korea. These results suggest the need for policy reforms aimed at reducing hospitalization for heart failure, pneumonia, and UTI, especially among Medical Aid patients.
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