목 통증 재발의 위험인자에 관한 추적 조사: 국민건강보험자료 기반 전국단위 코호트 연구
A longitudinal Investigation of Risk Factors for Neck Pain Recurrence: A Nationwide Cohort Study Based on National Health Insurance Data
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초록
본 연구의 목적은 건강보험자료 공유서비스를 이용하여 전국 단위 코호트를 기반으로 목 통증 재발의 특성과 그 위험인자를 파악하는 것이다. 한국 건강보험 데이터베이스를 통해 2020년 1년간 목 통증 (ICD 10 codes: M54.2)으로 입내원한 환자 1,182,230명의 2년 간의 의료기록을 추출하였다. 추출된 변수는 나이, 성별, 건강보험료 분위, 지역보건취약지역 점수, 최초 발병 시 발병기간, 총 입내원 기간, 발병 시 물리치료와 약물치료의 유무로 선정하였다. 목 통증의 재발률과 재발 위험인자를 분석하기 위해 다변량 로지스틱 회귀분석을 시행하였다. 대상자 중 19.5%인 230,259명이 2년 안에 목 통증의 재발을 경험하였으며, 여성이거나 높은 연령에서 더 높은 비율의 재발이 나타났다. 회귀분석의 결과 높은 연령(OR=1.58), 여성(OR=1.11), 의료수급권자(OR=1.45), 높은 지역보건취약지역 점수(OR=1.20) 및 긴 최초 발병기간(OR=1.02)은 목 통증 재발의 위험을 증가시키는 요인으로 나타났다. 반면, 높은 건강보험료 분위(OR=0.95), 최초 발병기간 중 긴 입내원 기간(OR=0.95) 및 약물치료를 받은 경우(OR=0.89)는 목 통증 재발 위험을 감소시키는 요인으로 관찰되었다. 이 연구는 의료서비스 제공자들에게 목 통증 재발의 이해를 돕고, 예방과 관리를 위한 집중적이며 장기적인 중재를 시행하는데 근거를 제시하였다고 생각된다.
Abstract
The purpose of this study was to identify the characteristics and risk factors of neck pain recurrence using the National Health Insurance Data Sharing Service that utilizes a nationwide cohort in South Korea. We extracted 2 years of medical records from the National Health Insurance database for 1,182,230 patients who visited healthcare services with neck pain (ICD 10 codes: M54.2) in 2020. Selected variables included age, gender, health insurance premium decile, regional health vulnerability index, duration of first episode, length of stay in healthcare, and the use of physical therapy and drug treatments at the first episode. Multivariate logistic regression analysis was conducted to analyze the recurrence rate and risk factors for neck pain recurrence. Among the subjects, 230,259 individuals (19.5%) experienced a recurrence of neck pain within two years, with a higher recurrence rate observed in elders and females. The regression analysis revealed that the risk of neck pain recurrence increased with older age (OR=1.58), being female (OR= 1.11), being a medical aid recipient (OR=1.45), residing in a region with a high health vulnerability index (OR=1.20), and longer duration of first episode (OR= 1.02). Conversely, higher health insurance premium decile (OR=0.95), longer stay in healthcare (OR=0.95), and receiving drug treatment (OR=0.89) were associated with a decrease in neck pain recurrence. This study contributes to improve understanding of neck pain recurrence and provide evidence of focused and long-term treatment plans for the prevention and management of neck pain recurrence for healthcare providers.
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