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만성 폐쇄성 폐질환의 의료이용 현황 및 관련 요인: 전국조사를 통한 1990년에서 2008년까지 변화추이
이기동 ( Gi Dong Lee ),도세록 ( Se Rok Doh ),이재승 ( Jae Seung Lee ),노창석 ( Chang Suk Noh ),이상도 ( Sang Do Lee ),김동순 ( Dong Soon Kim ),오연목 ( Yeon Mok Oh ) 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.4
Background: 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.