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2015年至2017年韩国踝关节扭伤患者医疗服务分析:基于健康保险审查与评估服务全国患者样本数据库的横断面研究

Analysis of medical services provided to patients with ankle sprains in Korea between 2015 and 2017: a cross-sectional study of the health insurance review and assessment service national patient sample database.

作者信息

Ryu Ho-Sun, Jung Boyoung, Yeo Jiyoon, Kim Jae-Hong, Nam Dongwoo, Ha In-Hyuk

机构信息

Jaseng Hospital of Korean Medicine, Gangnam-gu, Republic of Korea.

Department of Health Administration, Hanyang Women's University, Seoul, Republic of Korea.

出版信息

BMJ Open. 2020 Sep 24;10(9):e039297. doi: 10.1136/bmjopen-2020-039297.

Abstract

OBJECTIVES

To provide useful information for policy-makers and clinicians by analysing the medical service use-divided into Western medicine (WM) and Korean medicine (KM)-of patients with ankle sprains in South Korea between 2015 and 2017.

DESIGN

Cross-sectional, retrospective, observational study.

SETTING

Tertiary hospitals, WM hospitals, WM clinics, KM hospitals, KM clinics and others in South Korea.

PARTICIPANTS

We analysed claim data and patient information from the 2015 to 2017 Health Insurance Review and Assessment National Patient Sample (HIRA-NPS) dataset, including 151 415 patients diagnosed with a 'dislocation, sprain and strain of joints and ligaments at ankle and foot level' (10th revision of the International Statistical Classification of Diseases code S93) who used medical services at least once in 3 years between January 2015 and December 2017 in South Korea.

PRIMARY AND SECONDARY OUTCOME MEASURES

Cost of medical care, number of consultations, type of institution visited, types of treatment.

RESULTS

There were 160 200 consultations and 53 044 patients in 2015, 149 956 consultations and 50 830 patients in 2016 and 140 651 consultations and 47 541 patients in 2017. The total treatment costs were US$3 355 044.21, US$3 245 827.70 and US$3 128 938.46 in 2015, 2016 and 2017, respectively. The most common age was 10-19 years. The most frequent type of visit was KM outpatient visit (56%). Physiotherapy was most common in WM outpatient visits, while acupuncture was most common in KM visits. Most patients used one institution, rather than alternating between WM and KM.

CONCLUSIONS

By identifying the trends and costs of treatment methods used for ankle sprains and comparing WM and KM, our data provide basic information for future health policy-making. In addition, the duality of the Korean medical system is highlighted as a possible cause of increased costs.

摘要

目的

通过分析2015年至2017年韩国踝关节扭伤患者的医疗服务使用情况(分为西医和韩医),为政策制定者和临床医生提供有用信息。

设计

横断面、回顾性观察研究。

地点

韩国的三级医院、西医医院、西医诊所、韩医医院、韩医诊所及其他医疗机构。

参与者

我们分析了2015年至2017年健康保险审查与评估国家患者样本(HIRA-NPS)数据集的理赔数据和患者信息,其中包括151415名被诊断为“踝关节和足部关节及韧带脱位、扭伤和拉伤”(国际疾病分类第10版代码S93)的患者,他们在2015年1月至2017年12月的3年中至少使用过一次医疗服务。

主要和次要结局指标

医疗费用、就诊次数、就诊机构类型、治疗类型。

结果

2015年有160200次就诊和53044名患者,2016年有149956次就诊和50830名患者,2017年有140651次就诊和47541名患者。2015年、2016年和2017年总治疗费用分别为3355044.21美元、3245827.70美元和3128938.46美元。最常见的年龄为10 - 19岁。最常见的就诊类型是韩医门诊就诊(56%)。西医门诊就诊中物理治疗最常见,而韩医就诊中针灸最常见。大多数患者只使用一家机构,而非在西医和韩医之间交替。

结论

通过确定踝关节扭伤治疗方法的趋势和成本,并比较西医和韩医,我们的数据为未来的卫生政策制定提供了基础信息。此外,韩国医疗体系的二元性被强调为成本增加的一个可能原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0987/7517580/9fe533986443/bmjopen-2020-039297f01.jpg

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