Park Hye Jung, Byun Min Kwang, Kim Hyung Jung, Ahn Chul Min, Rhee Chin Kook, Kim Kyungjoo, Kim Bo Yeon, Bae Hye Won, Yoo Kwang-Ha
1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro Gangnam-gu, Seoul, 135-720 South Korea.
2Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Allergy Asthma Clin Immunol. 2018 Jul 10;14:29. doi: 10.1186/s13223-018-0250-0. eCollection 2018.
Asthma requires regular follow-up visits and sustained medication use. Although several studies have reported the importance of adherence to medication and compliance with the treatment, none to date have reported the importance of regular follow-up visits. We investigated the effects of regular clinical visits on asthma exacerbation.
We used claims data in the national medical insurance review system provided by the Health Insurance Review and Assessment Service of Korea. We included subjects aged ≥ 15 years with a diagnosis of asthma, and who were prescribed asthma-related medication, from July 2013 to June 2014. Regular visitors (frequent visitors) were defined as subjects who visited the hospital for follow-up of asthma three or more times per year.
Among 729,343 subjects, 496,560 (68.1%) were classified as regular visitors. Old age, male sex, lack of medical aid insurance, attendance of a tertiary hospital, a high Charlson comorbidity index, and a history of admission for exacerbated asthma in the previous year were significant determining factors for regular visitor status. When we adjusted for all these factors, frequent visitors showed a lower risk of asthma exacerbation requiring general ward admission (odds ratio [OR] 0.48; 95% confidence interval [CI] 0.47-0.50; < 0.001), emergency room admission (OR 0.83; 95% CI 0.79-0.86; < 0.001), and intensive care unit admission (OR 0.49; 95% CI 0.44-0.54; < 0.001) than infrequent visitors.
Regular clinical visits are significantly associated with a reduced risk of asthma exacerbation requiring hospital admission in Korean adults with asthma.
哮喘需要定期随访和持续用药。尽管多项研究报告了坚持用药和遵守治疗方案的重要性，但迄今为止尚无研究报告定期随访的重要性。我们调查了定期临床就诊对哮喘急性发作的影响。
我们使用了韩国健康保险审查与评估服务机构提供的国家医疗保险审查系统中的理赔数据。纳入2013年7月至2014年6月期间年龄≥15岁、诊断为哮喘且开具了哮喘相关药物的受试者。定期就诊者（频繁就诊者）定义为每年因哮喘随访到医院就诊三次或以上的受试者。
在729343名受试者中，496560名（68.1%）被归类为定期就诊者。年龄较大、男性、没有医疗救助保险、在三级医院就诊、Charlson合并症指数较高以及上一年有因哮喘急性加重住院史是定期就诊者状态的重要决定因素。在对所有这些因素进行调整后，频繁就诊者哮喘急性加重需要普通病房住院（比值比[OR]0.48；95%置信区间[CI]0.47 - 0.50；<0.001）、急诊室住院（OR 0.83；95% CI 0.79 - 0.86；<0.001）和重症监护病房住院（OR 0.49；95% CI 0.44 - 0.54；<0.001）的风险低于不频繁就诊者。
在韩国成年哮喘患者中，定期临床就诊与哮喘急性加重需要住院治疗的风险降低显著相关。
