title: The health care burden of high grade chronic obstructive pulmonary disease in Korea: analysis of the Korean Health Insurance Review and Assessment Service data.
abstract: BACKGROUND
  Patients with high grade chronic pulmonary obstructive disease (COPD) account for much of the COPD-related mortality and incur excessive financial burdens and medical care utilization. We aimed to determine the characteristics and medical care use of such patients using nationwide data from the Korean Health Insurance Review and Assessment Service in 2009.
  
  
  METHODS
  Patients with COPD were identified by searching with the International Classification of Diseases-10th Revision for those using medication. Patients with high grade COPD were selected based on their patterns of tertiary institute visits and medication use.
  
  
  RESULTS
  The numbers of patients with high grade COPD increased rapidly in Korea during the study period, and they showed a high prevalence of comorbid disease. The total medical costs were over three times higher in patients with high grade COPD compared with those without it ($3,744 versus $1,183; P < 0.001). Medication costs comprised the largest portion of medical cost, but most impact came from hospitalization and exacerbation in both groups of patients. COPD grade and hospitalization in the previous year were the major factors affecting medical costs and days of utilizing health care resources.
  
  
  CONCLUSIONS
  Patients with high grade COPD impose a high economic burden on the health care system in Korea. Prevention of progression to high grade COPD is important, both clinically and economically.
authors.affiliation: Office of Health Service Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
authors.forename: JinHee
authors.initials: J
authors.lastname: Kim
authors.forename: Chin Kook
authors.initials: CK
authors.lastname: Rhee
authors.forename: Kwang Ha
authors.initials: KH
authors.lastname: Yoo
authors.forename: Young Sam
authors.initials: YS
authors.lastname: Kim
authors.forename: Sei Won
authors.initials: SW
authors.lastname: Lee
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Park
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Lee
authors.forename: YeonMok
authors.initials: Y
authors.lastname: Oh
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Lee
authors.forename: Yuri
authors.initials: Y
authors.lastname: Kim
authors.forename: KyungJoo
authors.initials: K
authors.lastname: Kim
authors.forename: HyoungKyu
authors.initials: H
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057225:Data Mining; D018450:Disease Progression; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D056910:Republic of Korea / Q000453:epidemiology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: COPD; health care utilization; medical cost; population characteristics