치료재료 사용의 확산과 중단: 2010-2024년 스텐트 및 풍선 카테터류 청구 경향 분석
Diffusion and De-adoption of Medical Devices: Analysis of Trends in Stent and Balloon Catheter Use in Korea, 2010-2024
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Objectives: This study examined diffusion and de-adoption of cardiovascular devices in Korea. Methods: Nationwide claims data (2010–2024) from the Health Insurance Review and Assessment Service were analyzed for drug-eluting stents (DES), bare metal stents (BMS), percutaneuous transluminal angioplasty (PTA) ballon, and percutaneous transluminal coronary angioplasty (PTCA) ballon. Annual trends were estimated using linear regression, and segmented regression was use to test changes before and after the 2014 policy change which removed stent limits. Results: Use of DES, PTA ballons and PTCA balloons increased steadily, with PTA balloons showing the fastest growth (CAGR 12%). BMS declined sharply (–26% CAGR), nearly disappearing after 2020. Segmented regression showed no significant policy effect on DES, while BMS decline slowed and remained downward after 2014. Regional use was concentrated in Seoul and Gyeonggi, and clinics rapidly adopted PTA balloons from 2018. Conclusions: Healthcare institutions showed rapid diffusion of new medical devices and selective de-adoption of older varieties. The 2014 policy reinforced existing patterns rather than creating new shifts. These results highlight the need for reimbursement and technology assessment policies that reflect regional and institutional heterogeneity.
Abstract
Objectives: This study examined diffusion and de-adoption of cardiovascular devices in Korea. Methods: Nationwide claims data (2010–2024) from the Health Insurance Review and Assessment Service were analyzed for drug-eluting stents (DES), bare metal stents (BMS), percutaneuous transluminal angioplasty (PTA) ballon, and percutaneous transluminal coronary angioplasty (PTCA) ballon. Annual trends were estimated using linear regression, and segmented regression was use to test changes before and after the 2014 policy change which removed stent limits. Results: Use of DES, PTA ballons and PTCA balloons increased steadily, with PTA balloons showing the fastest growth (CAGR 12%). BMS declined sharply (–26% CAGR), nearly disappearing after 2020. Segmented regression showed no significant policy effect on DES, while BMS decline slowed and remained downward after 2014. Regional use was concentrated in Seoul and Gyeonggi, and clinics rapidly adopted PTA balloons from 2018. Conclusions: Healthcare institutions showed rapid diffusion of new medical devices and selective de-adoption of older varieties. The 2014 policy reinforced existing patterns rather than creating new shifts. These results highlight the need for reimbursement and technology assessment policies that reflect regional and institutional heterogeneity.