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Abstract
Objectives This study examined National Health Insurance claims data to investigate the epidemiology of shoulder disorders in Korea. Detailed information on medical services and related costs was assessed by major shoulder disorder category.
Design and setting The 2014 National Patient Sample dataset provided by the Health Insurance Review and Assessment Service was analysed. Among shoulder-related diagnosis codes, adhesive capsulitis of the shoulder (ACS), rotator cuff syndrome (RCS) and shoulder impingement syndrome (SIS) categories were of highest prevalence. Sociodemographic characteristics and medical service use, frequency and medical costs regarding common shoulder disorders were evaluated.
Results The majority of patients with shoulder disorder received ambulatory care (97%). Total and per-patient expenses were highest in patients with RCS. The number of inpatients with RCS was more than twice that of the other two groups, and patients with RCS were more likely to receive surgical management compared with patients with ACS and SIS. Prevalence of shoulder disorders was highest among subjects in their 50s for all three groups. Primary care physicians treated 75.80% of patients with ACS, 56.99% of patients with RCS and 48.06% of patients with SIS, respectively, outlining the difference in medical institution usage patterns. In all three groups, the highest proportion of patients visited orthopaedic surgeons out of medical departments. In the ACS and SIS groups, cost of visits (consultations) took up the largest part of total expenses at 32.30% and 18.88%, respectively, while cost of procedure/surgery constituted the largest portion in patients with RCS (37.77%). The usage proportion of subcutaneous or intramuscular and intra-articular injections ranged between 20% and 30% for outpatients in all three groups.
Conclusions Medical service use, frequency and cost distributions relating to major shoulder disorders in Korea were assessed using nationwide claims data. These findings are expected to aid policy-makers as well as researchers and practitioners as basic healthcare data.
- shoulder
- international health services
- epidemiology
- health economics
- rheumatology
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Footnotes
Contributors HJ, J-SS, JL, YP, YKS and J-HC conceptualised the study. YJL, M-rK, WK and I-HH acquired and analysed the data. HJ, YJL, M-rK, WK and I-HH drafted the manuscript. YJL, J-SS, JL, YP, YKS and J-HC critically revised the manuscript. YJL made valuable suggestions in the revision process. All authors gave approval of the final submitted version.
Funding This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HB16C0011).
Competing interests None declared.
Patient consent Written informed consent was not obtained from participants as the current sample dataset was extracted from Korean National Health Insurance claims data and made publicly available for research purposes by the Health Insurance Review and Assessment Service (HIRA). All data were removed of identifying personal information by HIRA prior to analysis in this study and therefore remained anonymous.
Ethics approval The present study was reviewed and approved by the Institutional Review Board of Jaseng Hospital of Korean Medicine (JASENG 201611002). Written informed consent was not obtained from participants as the current sample dataset was extracted from Korean National Health Insurance claims data and made publicly available for research purposes by the Health Insurance Review and Assessment Service (HIRA). All data were removed of identifying personal information by HIRA prior to analysis in this study and therefore remained anonymous.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement HIRA data are third-party data not owned by the authors. Raw data are made available from the Health Insurance Review and Assessment Service (HIRA) in Korea through visit or mail upon direct, email or fax submission of the dataset request form and declaration of data use (http://opendata.hira.or.kr/home.do) and payment of the transfer of data request fee (300 000 KRW per dataset).