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Evaluation of use and cost of medical care of common lumbar disorders in Korea: cross-sectional study of Korean Health Insurance Review and Assessment Service National Patient Sample data
  1. Yong-Jun Ahn1,
  2. Joon-Shik Shin1,
  3. Jinho Lee1,
  4. Yoon Jae Lee1,
  5. Me-Riong Kim1,
  6. Ki Byung Park1,
  7. Jun-Hwan Lee2,3,
  8. Kyung-Min Shin2,
  9. In-Hyuk Ha1
  1. 1Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
  2. 2Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
  3. 3University of Science & Technology (UST), Korean Medicine Life Science, Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
  1. Correspondence to Dr In-Hyuk Ha; hanihata{at}gmail.com

Abstract

Objectives To assess medical care and costs of the 3 highest prevalence lumbar disorders—non-specific low back pain (nLBP), intervertebral disc disorder (IDD) and spinal stenosis (SS)—from national billing data to provide basic information for standards of appropriate management.

Design Retrospective analysis of National Health Insurance National Patient Sample data provided by the Korean Health Insurance Review and Assessment Service (HIRA).

Setting 2011 claims data from all medical institutions which filed billing statements to HIRA.

Participants A total of 135 561 patients with lumbar disorder who received medical services during 2011.

Outcome measures Patient characteristics, medical procedures, medication, cost, injection and surgery.

Results In the nLBP and IDD groups, the 50–59 age range had the highest prevalence, whereas prevalence increased with age in SS. All 3 groups showed a higher percentage in women. The average treatment cost was 196 552 KRW in the nLBP and 362 050 KRW in the IDD group, and highest in the SS group at 439 025 KRW. While in the nLBP group women spent more on medical expenses, in the other 2 groups men showed higher expenditure. Expenditure grew with age in the nLBP and SS groups, whereas that of the IDD group peaked in their 40s. Analgesics were used in 73.43% of patients with nLBP, 82.64% of patients with IDD and 86.46% of patients with SS, and opioids in 4.12% of patients with IDD and 5.36% of patients with SS. Surgery rates were highest in the SS group at 4.85%, with 0.9% for nLBP and 4.59% for IDD. The most frequent injection code was lumbar/caudal epidural nerve block. Expenditure and surgery rates were higher in the injection than in the non-injection subgroup in all 3 groups.

Conclusions Patterns of medical care of most frequent lumbar disorders from HIRA data showed significant difference between groups and provide a basic standard for future usual care guidelines linked with health policy and budget appropriation.

  • cost of care
  • spinal stenosis
  • intervertebral disc disorder
  • nonspecific low back pain
  • Health Insurance Review & Assessment Service Claims Data
  • National Patient Sample

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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