The Korean Journal of Gastroenterology (대한소화기학회지)

The Korean Society of Gastroenterology (대한소화기학회)
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Health Care Costs of Digestive Diseases in Korea

우리나라 소화기질환 환자의 질병비용 추계

  • Jung, Hye-Kyung (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Jang, Bo-Hyoung (National Evidence-based Healthcare Collaborating Agency) ;
  • Kim, Youn-Hee (National Evidence-based Healthcare Collaborating Agency) ;
  • Park, Joo-Yeon (National Evidence-based Healthcare Collaborating Agency) ;
  • Park, Sun-Young (National Evidence-based Healthcare Collaborating Agency) ;
  • Nam, Mi-Hee (National Evidence-based Healthcare Collaborating Agency) ;
  • Choi, Myung-Gyu (National Evidence-based Healthcare Collaborating Agency)
  • 정혜경 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 장보형 (한국보건의료연구원) ;
  • 김윤희 (한국보건의료연구원) ;
  • 박주연 (한국보건의료연구원) ;
  • 박선영 (한국보건의료연구원) ;
  • 남미희 (한국보건의료연구원) ;
  • 최명규 (한국보건의료연구원)
  • Published : 2011.12.25
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Abstract

Background/Aims: Gastrointestinal (GI) diseases impose a heavy economic burden. We aimed to provide the first report on the health care utilization and costs of GI diseases in Korea. Methods: We collected the data from all insurance claims database of National Health Insurance Corporation in Korea and the cause of death database in 2007 of Korea National Statistical Office. We compiled information about all digestive disease as a primary diagnosis on clinic visits, hospitalization, and cause of death from these databases. Results: Seventeen million people (35.6%) had a diagnosis of GI diseases during the year 2007. Among them, the proportion of patients with upper GI diseases was prevalent in 54.9% (9.5 million patients/year). The 1/4 patients in out-patients clinic had any one of gastroesophageal reflux disease, irritable bowel syndrome and constipation. Thirteen percent of the total direct cost in 2007 was attributed to all GI diseases, which was 3,649 billion won (0.4% of GDP). The patients with hospitalization occupied by 5% of all patients with GI diseases, however, attributed to 58.9% of GI-related direct costs. GI malignancy was the major cause of medical expenses in hospitalization. Stomach cancer continues to be the leading cause of GI-related death in Korea. Conclusions: GI diseases causes a heavy socioeconomic burden with high morbidity of functional GI disorders in outpatients care and high mortality of GI malignancy in inpatient care. This report highlights the healthcare utilization burden of GI diseases for researchers and public health policy maker to create new directions of integrated researches and health care plan.

목적: 소화기질환에 대한 사회경제적 부담의 추계는 제한된 의료자원을 합리적으로 배분하기 위해 매우 중요하다. 이번 연구에서는 전 국민이 적용받는 건강보험 청구자료를 이용하여 소화기질환의 의료이용 정도와 직접비용을 산정하고자 하였다. 대상 및 방법: 2007년 한 해 동안 건강보험심사평가원 청구자료를 사용하여 주상병이 소화기질환인 환자를 포함하였다. 의료비용은 건강보험 통계연보와 건강보험 심사평가원의 정보공개제도를 이용하였고 사망률은 통계청의 사망률 자료분석을 이용하였다. 결과: 2007년 소화기질환으로 인한 총 진료 실인원수는 17,248,720명으로 2007년 인구 100명 중 36명은 소화기질환으로 의료기관을 이용하였다. 입원은 866,785명으로 전체 입원 진료 실인원수의 18.6%, 소화기질환으로 발생한 환자의 5%였으며, 외래 진료 실인원수는 17,015,915명으로 전체 외래 이용자 중 39.5%였다. 상부위장관질환으로 인한 진료 실인원수는 전체 소화기질환 실인원수의 54.9%였고, 하부위장관질환, 간질환, 소화기 악성질환 및 췌담도질환의 순서로 빈발하였다. 위식도역류질환의 인구 대비 환자율은 3.6%, 과민성장증후군은 3.0%, 변비 2.6%로 이 세 질환은 외래에서 발생하는 소화기질환의 1/4이었다. 직접비용은 전체 약 3조 6,489억원으로 GDP 대비 0.4%의 규모이다. 외래에서 발생한 총 진료비는 소화기질환 총 진료비의 41.1%였고, 이 중 상부위장관질환이 37.7%, 악성질환이 22.1%의 순서였다. 소화기질환 입원으로 발생한 총 진료비는 1조 6,157억원이고 악성종양으로 인한 입원비용이 가장 높았다. 단일 소화기질환 중 위암이 가장 흔한 사망의 원인이었다. 결론: 의료기관을 방문하는 환자의 10명 중 3.6명이 소화기질환으로 유병률이 높았고, 소화기 악성종양은 사망률 역시 높았다. 외래에서는 위염, 위식도역류질환, 과민성장증후군 및 변비의 4대 질환으로 인한 높은 의료 이용률이, 입원환자에서는 악성질환으로 인한 높은 의료비용이 소화기질환으로 인한 질병부담의 주요 원인이었다.

Keywords

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