Park Choon Seon, Kang Hye-Young, Kwon Il, Kang Dae Ryong, Jung Hye Young
Health Insurance Review Agency, Graduate School of Public Health, Yonsei University.
J Prev Med Public Health. 2006 Sep;39(5):397-403.
We estimated the asthma-related health care utilization and costs in Korea from the insurer' s and societal perspective.
We extracted the insurance claims records from the Korea National Health Insurance claims database for determining the health care services provided to patients with asthma in 2003. Patients were defined as having asthma if they had > or =2 medical claims with diagnosis of asthma and they had been prescribed anti-asthma medicines. Annual claims records were aggeregated for each patient to produce patient-specific information on the total utilization and costs. The total asthma-related cost was the sum of the direct healthcare costs, the transportation costs for visits to healthcare providers and the patient's or caregivers' costs for the time spent on hospital or outpatient visits.
A total of 699,603 people were identified as asthma patients, yielding an asthma prevalence of 1.47%. Each asthma patient had 7.56 outpatient visits, 0.01 ED visits and 0.02 admissions per year to treat asthma. The per-capita insurance-covered costs increased with age, from 128,276 Won for children aged 1 to 14 years to 270,729 Won for those aged 75 or older. The total cost in the nation varied from 121,865 million to 174,949 million Won depending on the perspectives. From a societal perspective, direct healthcare costs accounted for 84.9%, transportation costs for 15.1% and time costs for 9.2% of the total costs.
Hospitalizations and ED visits represented only a small portion of the asthma-related costs. Most of the societal burden was attributed to direct medical expenditures, with outpatient visits and medications emerging as the single largest cost components.
我们从保险公司和社会的角度估算了韩国与哮喘相关的医疗保健利用情况及成本。
我们从韩国国民健康保险理赔数据库中提取保险理赔记录，以确定2003年为哮喘患者提供的医疗服务。如果患者有≥2条诊断为哮喘的医疗理赔记录且已开具抗哮喘药物，则被定义为患有哮喘。对每位患者的年度理赔记录进行汇总，以生成患者特定的总利用情况和成本信息。与哮喘相关的总成本是直接医疗成本、前往医疗服务提供者的交通成本以及患者或护理人员在住院或门诊就诊时所花费时间的成本之和。
共识别出699,603名哮喘患者，哮喘患病率为1.47%。每位哮喘患者每年有7.56次门诊就诊、0.01次急诊就诊和0.02次住院治疗哮喘。人均保险覆盖成本随年龄增长而增加，从1至14岁儿童的128,276韩元增至75岁及以上人群的270,729韩元。根据不同视角，全国总成本在1218.65亿至1749.49亿韩元之间。从社会角度来看，直接医疗成本占总成本的84.9%，交通成本占15.1%，时间成本占9.2%。
住院和急诊就诊仅占与哮喘相关成本的一小部分。大部分社会负担归因于直接医疗支出，门诊就诊和药物成为单一最大成本组成部分。
