Joo Hwansoo, Lee Yoon Jae, Shin Joon-Shik, Lee Jinho, Kim Me-Riong, Koh Wonil, Park Yeoncheol, Song Yun Kyung, Cho Jae-Heung, Ha In-Hyuk
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, The Republic of Korea.
Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul, The Republic of Korea.
BMJ Open. 2017 Jul 12;7(7):e015848. doi: 10.1136/bmjopen-2017-015848.
This study examined National Health Insurance claims data to investigate the epidemiology of shoulder disorders in Korea. Detailed information on medical services and related costs was assessed by major shoulder disorder category.
The 2014 National Patient Sample dataset provided by the Health Insurance Review and Assessment Service was analysed. Among shoulder-related diagnosis codes, adhesive capsulitis of the shoulder (ACS), rotator cuff syndrome (RCS) and shoulder impingement syndrome (SIS) categories were of highest prevalence. Sociodemographic characteristics and medical service use, frequency and medical costs regarding common shoulder disorders were evaluated.
The majority of patients with shoulder disorder received ambulatory care (97%). Total and per-patient expenses were highest in patients with RCS. The number of inpatients with RCS was more than twice that of the other two groups, and patients with RCS were more likely to receive surgical management compared with patients with ACS and SIS. Prevalence of shoulder disorders was highest among subjects in their 50s for all three groups. Primary care physicians treated 75.80% of patients with ACS, 56.99% of patients with RCS and 48.06% of patients with SIS, respectively, outlining the difference in medical institution usage patterns. In all three groups, the highest proportion of patients visited orthopaedic surgeons out of medical departments. In the ACS and SIS groups, cost of visits (consultations) took up the largest part of total expenses at 32.30% and 18.88%, respectively, while cost of procedure/surgery constituted the largest portion in patients with RCS (37.77%). The usage proportion of subcutaneous or intramuscular and intra-articular injections ranged between 20% and 30% for outpatients in all three groups.
Medical service use, frequency and cost distributions relating to major shoulder disorders in Korea were assessed using nationwide claims data. These findings are expected to aid policy-makers as well as researchers and practitioners as basic healthcare data.
本研究通过分析国民健康保险理赔数据，调查韩国肩部疾病的流行病学情况。按主要肩部疾病类别评估了医疗服务及相关费用的详细信息。
分析了健康保险审查与评估服务机构提供的2014年全国患者样本数据集。在与肩部相关的诊断编码中，肩周炎（ACS）、肩袖综合征（RCS）和肩部撞击综合征（SIS）的患病率最高。评估了常见肩部疾病患者的社会人口学特征、医疗服务使用情况、频率及医疗费用。
大多数肩部疾病患者接受门诊治疗（97%）。RCS患者的总费用和人均费用最高。RCS住院患者数量是其他两组的两倍多，与ACS和SIS患者相比，RCS患者更有可能接受手术治疗。所有三组中，50多岁人群的肩部疾病患病率最高。初级保健医生分别治疗了75.80%的ACS患者、56.99%的RCS患者和48.06%的SIS患者，这凸显了医疗机构使用模式的差异。在所有三组中，患者就诊科室中骨科医生的占比最高。在ACS和SIS组中，就诊（会诊）费用分别占总费用的最大部分，为32.30%和18.88%，而在RCS患者中，手术/程序费用占最大部分（37.77%）。所有三组门诊患者皮下或肌肉注射及关节内注射的使用比例在20%至30%之间。
利用全国性理赔数据评估了韩国主要肩部疾病的医疗服务使用情况、频率及费用分布。这些研究结果有望作为基础医疗数据，为政策制定者、研究人员及从业者提供帮助。
