건강보험심사평가원 소아청소년 환자표본자료를 활용한 폐렴구균 감염 관련 질환의 추세 분석: 유병률, 직접의료비용, 항생제 처방을 중심으로
Trend Analysis of Pneumococcal Infection-Related Disease Using HIRA-Pediatric Patient Sample Data: Focus on the Prevalence, Direct Medical Cost, and Antibiotic Prescriptions
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: To estimate the trend of pneumococcal infections in children and adolescents (aged 0–19 years old) in Korea, including healthcare utilization, the annual medical costs, and prescription history of antibiotics. Methods: This study utilized the Pediatric Patient Sample data from the Health Insurance Review & Assessment Service (HIRA-PPS) between 2009 to 2019. We defined pneumococcal infection diseases as all-caused pneumonia (ACP) and acute otitis media (AOM) with H650, H651, H660. We analyzed healthcare utilization including outpatient visits, inpatient visit, the length of hospitalization, and the medical costs. In addition, we analyzed the trend of prescriptions containing relevant antibiotic and classified them by inpatient or outpatient status. All analysis was conducted by statistical analysis system enterprise. Results: Annually, an average of 174,978 patients were selected during 2009–2019, showing a general decrease in ACP and AOM cases over the years. The 0–4 age group accounted for approximately 60% of cases annually. Healthcare utilization revealed that ACP patients averaged 1.75 hospital admissions and 10.81 hospital days, with outpatient visits averaging 9.62, reducing to 1.77 when adjusted for re-visits within 7 days. For AOM patients, the averages were 1.27 hospital admissions, 7.23 hospital days, and 16.89 outpatient visits, which reduced to 2.25 after adjustment. Antibiotic prescriptions averaged 600,000 annually, with different trends for ACP and AOM. Outpatients mostly received single antibiotic therapy, with macrolides for ACP and penicillin for AOM. Hospitalized ACP patients had higher combination therapy rates. Conclusion: This study utilized HIRA-PPS to analyze trends in patients, healthcare utilization, and antibiotic prescriptions over 11 years for pneumococcal infection. Despite a general decline in ACP and AOM cases, the disease burden may remain significant due to increased medical costs. These findings offer useful insights into the clinical landscape and may inform outcomes research, such as economic evaluations and decision-making in Korea.
Abstract
Objectives: To estimate the trend of pneumococcal infections in children and adolescents (aged 0–19 years old) in Korea, including healthcare utilization, the annual medical costs, and prescription history of antibiotics. Methods: This study utilized the Pediatric Patient Sample data from the Health Insurance Review & Assessment Service (HIRA-PPS) between 2009 to 2019. We defined pneumococcal infection diseases as all-caused pneumonia (ACP) and acute otitis media (AOM) with H650, H651, H660. We analyzed healthcare utilization including outpatient visits, inpatient visit, the length of hospitalization, and the medical costs. In addition, we analyzed the trend of prescriptions containing relevant antibiotic and classified them by inpatient or outpatient status. All analysis was conducted by statistical analysis system enterprise. Results: Annually, an average of 174,978 patients were selected during 2009–2019, showing a general decrease in ACP and AOM cases over the years. The 0–4 age group accounted for approximately 60% of cases annually. Healthcare utilization revealed that ACP patients averaged 1.75 hospital admissions and 10.81 hospital days, with outpatient visits averaging 9.62, reducing to 1.77 when adjusted for re-visits within 7 days. For AOM patients, the averages were 1.27 hospital admissions, 7.23 hospital days, and 16.89 outpatient visits, which reduced to 2.25 after adjustment. Antibiotic prescriptions averaged 600,000 annually, with different trends for ACP and AOM. Outpatients mostly received single antibiotic therapy, with macrolides for ACP and penicillin for AOM. Hospitalized ACP patients had higher combination therapy rates. Conclusion: This study utilized HIRA-PPS to analyze trends in patients, healthcare utilization, and antibiotic prescriptions over 11 years for pneumococcal infection. Despite a general decline in ACP and AOM cases, the disease burden may remain significant due to increased medical costs. These findings offer useful insights into the clinical landscape and may inform outcomes research, such as economic evaluations and decision-making in Korea.
참고문헌 (15)
- Black RE, "Global, regional, and national causes of child mortality in 2008 : a systematic analysis", Lancet, 375, pp.1969~1987 (2010)
- World Health Organization, "WHO position paper : pneumococcal conjugate vaccines in infants and children under 5 years of age", Wkly Epidemiol Rec, 94, pp.85~104 (2019)
- "Immunizable infectious diseases-streptococcus pneumoniae infections"[URL]
- Lee H, "Serotypes of pneumococcus isolated from invasive infections in Korean children" (2016), Korea Disease Control and Prevention Agency
- "National childhood immunization rates"[URL]
- Byford S, "Economic note : cost of illness studies", BMJ, 320, pp.1335~ (2000)
- Tarricone R, "Cost-of-illness analysis. What room in health economics", Health Policy, 77, pp.51~63 (2006)
- Sohn S, "Evaluation of the effectiveness of pneumococcal conjugate vaccine for children in Korea with high vaccine coverage using a propensity score matched national population cohort", Int J Infect Dis, 93, pp.146~150 (2020)
- Sohn S, "Paradoxical health care utilization patterns among children in Korea who did not receive mandatory pneumococcal vaccination", Vaccine, 39, pp.1096~1100 (2021)
- Park S, "Guidelines for the antibiotics use in children with acute lower respiratory tract infections", Korea Disease Control and Prevention Agency, ~ (2017)
- Hu T, "Economic burden of acute otitis media, pneumonia, and invasive pneumococcal disease in children in the United States after the introduction of 13-valent pneumococcal conjugate vaccines during 2014-2018", BMC Health Serv Res, 23, pp.398~ (2023)
- Hu T, "Healthcare resource utilization and cost of pneumococcal disease in children in Germany, 2014-2019: a retrospective cohort study", Pneumonia (Nathan), 15, pp.7~ (2023)
- Mohanty S, "Healthcare resource utilisation and cost of pneumococcal disease from 2003 to 2019 in children ≤17 years in England", PLoS One, 18, pp.e0283084~ (2023)
- "Number of newborns"[URL]
- "Annual conversion factors by health care institution"[URL]