Risk factors for asthma-related healthcare use: Longitudinal analysis using the NHI claims database in a Korean asthma cohort

COREA study group

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Though insurance claims data are useful for researching asthma, they have important limitations, such as a diagnostic inaccuracy and a lack of clinical information. To overcome these drawbacks, we used the novel method by merging the clinical data from our asthma cohort with the National Health Insurance (NHI) claims data. Methods and Results: Longitudinal analysis of asthma-related healthcare use from the NHI claims database, merged with data of 736 patients registered in a Korean asthma cohort, was conducted for three consecutive years from registration of the cohort. Asthma-related asthma healthcare referred to outpatient and emergency department visits, hospitalizations, and the use of systemic corticosteroids. Univariate and multivariate logistic regression analysis was used to evaluate risk factors for asthma-related healthcare. Over three years after enrollment, many patients changed from tertiary to primary/secondary hospitals with a lack of maintenance of inhaled corticosteroid-based controllers. An independent risk factor for emergency visits was a previous history of asthma exacerbation. In hospitalizations, old age and Asthma Control Test (ACT) score variability were independent risk factors. An independent risk factor for per person cumulative duration of systemic corticosteroids was the FEV1 (Forced expiratory volume in one second)%. The use of systemic corticosteroids was independently associated with being female, the FEV1%, and ACT score variability. Conclusion: We found that old age, being female, long-standing asthma, a low FEV1%, asthma brittleness, asthma drug compliance, and a history of asthma exacerbation were independent risk factors for increased asthma-related healthcare use in Korea.

Original languageEnglish
Article numbere112844
JournalPloS one
Volume9
Issue number11
DOIs
Publication statusPublished - 2014 Nov 14

Fingerprint

Health insurance
health insurance
National Health Programs
asthma
health services
risk factors
Asthma
Databases
Delivery of Health Care
Adrenal Cortex Hormones
adrenal cortex hormones
Insurance
Brittleness
Merging
Regression analysis
Logistics
Controllers
Hospitalization
Pharmaceutical Preparations
insurance

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{09b7311715cf43a9857f2fbd9e23424b,
title = "Risk factors for asthma-related healthcare use: Longitudinal analysis using the NHI claims database in a Korean asthma cohort",
abstract = "Background: Though insurance claims data are useful for researching asthma, they have important limitations, such as a diagnostic inaccuracy and a lack of clinical information. To overcome these drawbacks, we used the novel method by merging the clinical data from our asthma cohort with the National Health Insurance (NHI) claims data. Methods and Results: Longitudinal analysis of asthma-related healthcare use from the NHI claims database, merged with data of 736 patients registered in a Korean asthma cohort, was conducted for three consecutive years from registration of the cohort. Asthma-related asthma healthcare referred to outpatient and emergency department visits, hospitalizations, and the use of systemic corticosteroids. Univariate and multivariate logistic regression analysis was used to evaluate risk factors for asthma-related healthcare. Over three years after enrollment, many patients changed from tertiary to primary/secondary hospitals with a lack of maintenance of inhaled corticosteroid-based controllers. An independent risk factor for emergency visits was a previous history of asthma exacerbation. In hospitalizations, old age and Asthma Control Test (ACT) score variability were independent risk factors. An independent risk factor for per person cumulative duration of systemic corticosteroids was the FEV1 (Forced expiratory volume in one second){\%}. The use of systemic corticosteroids was independently associated with being female, the FEV1{\%}, and ACT score variability. Conclusion: We found that old age, being female, long-standing asthma, a low FEV1{\%}, asthma brittleness, asthma drug compliance, and a history of asthma exacerbation were independent risk factors for increased asthma-related healthcare use in Korea.",
author = "{COREA study group} and Taehoon Lee and Jinhee Kim and Sujeong Kim and Kyoungjoo Kim and Yunjin Park and Yuri Kim and Lee, {Yoon Su} and Kwon, {Hyouk Soo} and Kim, {Sae Hoon} and Chang, {Yoon Seok} and Cho, {You Sook} and Jang, {An Soo} and Jungwon Park and Nahm, {Dong Ho} and Yoon, {Ho Joo} and Cho, {Sang Heon} and Cho, {Young Joo} and Choi, {Byoung Whui} and Moon, {Hee Bom} and Kim, {Tae Bum}",
year = "2014",
month = "11",
day = "14",
doi = "10.1371/journal.pone.0112844",
language = "English",
volume = "9",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "11",

}

Risk factors for asthma-related healthcare use : Longitudinal analysis using the NHI claims database in a Korean asthma cohort. / COREA study group.

In: PloS one, Vol. 9, No. 11, e112844, 14.11.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors for asthma-related healthcare use

T2 - Longitudinal analysis using the NHI claims database in a Korean asthma cohort

AU - COREA study group

AU - Lee, Taehoon

AU - Kim, Jinhee

AU - Kim, Sujeong

AU - Kim, Kyoungjoo

AU - Park, Yunjin

AU - Kim, Yuri

AU - Lee, Yoon Su

AU - Kwon, Hyouk Soo

AU - Kim, Sae Hoon

AU - Chang, Yoon Seok

AU - Cho, You Sook

AU - Jang, An Soo

AU - Park, Jungwon

AU - Nahm, Dong Ho

AU - Yoon, Ho Joo

AU - Cho, Sang Heon

AU - Cho, Young Joo

AU - Choi, Byoung Whui

AU - Moon, Hee Bom

AU - Kim, Tae Bum

PY - 2014/11/14

Y1 - 2014/11/14

N2 - Background: Though insurance claims data are useful for researching asthma, they have important limitations, such as a diagnostic inaccuracy and a lack of clinical information. To overcome these drawbacks, we used the novel method by merging the clinical data from our asthma cohort with the National Health Insurance (NHI) claims data. Methods and Results: Longitudinal analysis of asthma-related healthcare use from the NHI claims database, merged with data of 736 patients registered in a Korean asthma cohort, was conducted for three consecutive years from registration of the cohort. Asthma-related asthma healthcare referred to outpatient and emergency department visits, hospitalizations, and the use of systemic corticosteroids. Univariate and multivariate logistic regression analysis was used to evaluate risk factors for asthma-related healthcare. Over three years after enrollment, many patients changed from tertiary to primary/secondary hospitals with a lack of maintenance of inhaled corticosteroid-based controllers. An independent risk factor for emergency visits was a previous history of asthma exacerbation. In hospitalizations, old age and Asthma Control Test (ACT) score variability were independent risk factors. An independent risk factor for per person cumulative duration of systemic corticosteroids was the FEV1 (Forced expiratory volume in one second)%. The use of systemic corticosteroids was independently associated with being female, the FEV1%, and ACT score variability. Conclusion: We found that old age, being female, long-standing asthma, a low FEV1%, asthma brittleness, asthma drug compliance, and a history of asthma exacerbation were independent risk factors for increased asthma-related healthcare use in Korea.

AB - Background: Though insurance claims data are useful for researching asthma, they have important limitations, such as a diagnostic inaccuracy and a lack of clinical information. To overcome these drawbacks, we used the novel method by merging the clinical data from our asthma cohort with the National Health Insurance (NHI) claims data. Methods and Results: Longitudinal analysis of asthma-related healthcare use from the NHI claims database, merged with data of 736 patients registered in a Korean asthma cohort, was conducted for three consecutive years from registration of the cohort. Asthma-related asthma healthcare referred to outpatient and emergency department visits, hospitalizations, and the use of systemic corticosteroids. Univariate and multivariate logistic regression analysis was used to evaluate risk factors for asthma-related healthcare. Over three years after enrollment, many patients changed from tertiary to primary/secondary hospitals with a lack of maintenance of inhaled corticosteroid-based controllers. An independent risk factor for emergency visits was a previous history of asthma exacerbation. In hospitalizations, old age and Asthma Control Test (ACT) score variability were independent risk factors. An independent risk factor for per person cumulative duration of systemic corticosteroids was the FEV1 (Forced expiratory volume in one second)%. The use of systemic corticosteroids was independently associated with being female, the FEV1%, and ACT score variability. Conclusion: We found that old age, being female, long-standing asthma, a low FEV1%, asthma brittleness, asthma drug compliance, and a history of asthma exacerbation were independent risk factors for increased asthma-related healthcare use in Korea.

UR - http://www.scopus.com/inward/record.url?scp=84911474570&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84911474570&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0112844

DO - 10.1371/journal.pone.0112844

M3 - Article

C2 - 25397972

AN - SCOPUS:84911474570

VL - 9

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 11

M1 - e112844

ER -