Tuberc Respir Dis > Volume 70(4); 2011 > Article
Tuberculosis and Respiratory Diseases 2011;70(4):307-314.
DOI:    Published online April 1, 2011.
Trends and Factors in Health Care Utilization of Patients with Chronic Obstructive Pulmonary Disease in Korea: A Nationwide Survey from 1990 through 2008.
Gi Dong Lee, Se Rok Doh, Jae Seung Lee, Chang Suk Noh, Sang Do Lee, Dong Soon Kim, Yeon Mok Oh
1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
2Korea Institute for Health and Social Affairs, Seoul, Korea.
3Asthma Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. METHODS: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. RESULTS: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). CONCLUSION: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.
Key Words: Pulmonary Disease, Chronic Obstructive, Risk Factors, Health Care Surveys, Community Health Services

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