Risk Factors for Asthma-Related Healthcare Use: Longitudinal Analysis Using the NHI Claims Database in a Korean Asthma Cohort

Taehoon Lee, Jinhee Kim, Sujeong Kim, Kyoungjoo Kim, Yunjin Park, Yuri Kim, Yoon Su Lee, Hyouk-Soo Kwon, Sae-Hoon Kim, Yoon-Seok Chang, You Sook Cho, An-Soo Jang, Jung-Won Park, Dong-Ho Nahm, Ho-Joo Yoon, Sang-Heon Cho, Young-Joo Cho, Byoung Whui Choi, Hee-Bom Moon, Tae-Bum Kim and for the COREA study Group

PLOS ONE, 2014, vol. 9, issue 11, 1-12

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.

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0112844

DOI: 10.1371/journal.pone.0112844

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