우리나라 결핵 환자의 치료 장기화와 다약제내성결핵 발생에 영향을미치는 요인
Influential Factors to Prolonged Tuberculosis Treatment Duration and Multidrugresistant Tuberculosis Incidence
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Objectives: Tuberculosis (TB) is a very important infectious disease in Korea. Among OECD countries, Korea has been had the highest rate in TB incidence, prevalence and death. In this study, we analyzed influencing factors to prolonged TB treatment and multidrug-resistant TB (MDR-TB) incidence. Methods: We collected 2007-2009 TB claim data in the National health insurance data. TB patients who diagnosed TB for the fist time in 2008 were selected. Variables like gender, age, grade of insurance premium, length of stay in inpatient service, number of visits in outpatient services, type of employment, and size of residential of the patients were included to analyse. The prolonged TB treatment duration was defined as more than 9 months for TB treatment. MDR-TB incidence was defined as U88.0 or U88.1 in KCD-5. Provit model was used to find influencing factors to prolonged TB treatment and MDR-TB incidence. And marginal effects were calculated to analyse the influencing intensity of variables. Results: 42,347 patients diagnosed and treated TB in 2008. 14,317 patients (33.8%) took treatment more than 9 months. The risk of prolonged TB treatment duration were increased significantly in male (0.6%), young (<20, 14.7%) or old (≥75, 6.0%) age groups, and lower income groups (5.9%-2.5%). The risk of MDR-TB incidence were increased in lower income groups. Conclusions: Age and income level influenced th prolonged TB treatment and MDR-TB incidence risk. More effective TB managements have to be developed for young (<20) or old (≥75) age group, and low income groups.
Abstract
Objectives: Tuberculosis (TB) is a very important infectious disease in Korea. Among OECD countries, Korea has been had the highest rate in TB incidence, prevalence and death. In this study, we analyzed influencing factors to prolonged TB treatment and multidrug-resistant TB (MDR-TB) incidence. Methods: We collected 2007-2009 TB claim data in the National health insurance data. TB patients who diagnosed TB for the fist time in 2008 were selected. Variables like gender, age, grade of insurance premium, length of stay in inpatient service, number of visits in outpatient services, type of employment, and size of residential of the patients were included to analyse. The prolonged TB treatment duration was defined as more than 9 months for TB treatment. MDR-TB incidence was defined as U88.0 or U88.1 in KCD-5. Provit model was used to find influencing factors to prolonged TB treatment and MDR-TB incidence. And marginal effects were calculated to analyse the influencing intensity of variables. Results: 42,347 patients diagnosed and treated TB in 2008. 14,317 patients (33.8%) took treatment more than 9 months. The risk of prolonged TB treatment duration were increased significantly in male (0.6%), young (<20, 14.7%) or old (≥75, 6.0%) age groups, and lower income groups (5.9%-2.5%). The risk of MDR-TB incidence were increased in lower income groups. Conclusions: Age and income level influenced th prolonged TB treatment and MDR-TB incidence risk. More effective TB managements have to be developed for young (<20) or old (≥75) age group, and low income groups.
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