韩国乙型肝炎病毒感染的流行病学:15 年分析。
The Epidemiology of Hepatitis B Virus Infection in Korea: 15-Year Analysis.
机构信息
Department of Big DATA Strategy, National Health Insurance Service, Wonju, Korea.
Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
出版信息
J Korean Med Sci. 2024 Jan 29;39(4):e22. doi: 10.3346/jkms.2024.39.e22.
BACKGROUND
The purpose of this study is to investigate the epidemiological changes in chronic hepatitis B (CHB) and assess the impact of coronavirus disease 2019 (COVID-19) over the past 15 years in a region endemic to hepatitis B virus (HBV).
METHODS
National Health Insurance Service claims data of hepatitis B patients spanning from 2007 to 2021 was utilized. To compare the characteristics of the hepatitis B group, a control group adjusted for age and gender through propensity score matching analysis was established.
RESULTS
The number of patients with CHB has consistently increased over the past 15 years. The average age of the CHB patient group has shown a yearly rise, while the prevalence of male dominance has gradually diminished. The proportions of hepatocellular carcinoma, liver cirrhosis, and decompensation have exhibited a declining pattern, whereas the proportion of liver transplants has continuously risen. Patients with CHB have demonstrated significantly higher medical and medication costs compared to the control group. Moreover, patients with CHB have shown a higher prevalence of comorbidities along with a significantly higher rate of concomitant medication usage. During the COVID period, the HBV group experienced a substantial decrease in the number of outpatient visits and overall medical costs compared to the control group.
CONCLUSION
The epidemiology of CHB has undergone significant changes over the past 15 years, encompassing shifts in prevalence, severity, medical costs, and comorbidities. Furthermore, the impact of COVID-19 has been observed to decrease healthcare utilization among patients with CHB when compared to controls.
背景
本研究旨在调查慢性乙型肝炎(CHB)的流行病学变化,并评估过去 15 年来乙型肝炎病毒(HBV)流行地区 2019 年冠状病毒病(COVID-19)的影响。
方法
利用国家健康保险服务(NHIS)2007 年至 2021 年乙型肝炎患者的报销数据。通过倾向评分匹配分析,为乙型肝炎组建立了一个与年龄和性别相匹配的对照组,以比较两组的特征。
结果
过去 15 年来,CHB 患者的数量持续增加。CHB 患者组的平均年龄逐年上升,而男性优势的比例逐渐下降。肝癌、肝硬化和失代偿的比例呈下降趋势,而肝移植的比例持续上升。与对照组相比,CHB 患者的医疗和药物费用明显更高。此外,CHB 患者的合并症患病率更高,同时合并用药率也显著更高。在 COVID 期间,与对照组相比,HBV 组的门诊就诊次数和总医疗费用显著减少。
结论
过去 15 年来,CHB 的流行病学发生了重大变化,包括患病率、严重程度、医疗费用和合并症的变化。此外,与对照组相比,COVID-19 的影响导致 CHB 患者的医疗保健利用减少。