Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Identification and Validation of Osteoporotic Hip Fracture Using the National Health Insurance Database

건강보험데이타베이스를 이용한 골다공증성 고관절 골절 식별 및 타당도

  • Park, Chan-Mi (Health Insurance Review & Assessment Service) ;
  • Jang, Sun-Mee (Health Insurance Review & Assessment Service) ;
  • Jang, Su-Hyun (Health Insurance Review & Assessment Service) ;
  • Ha, Yong-Chan (The Korean Society of Bone Metabolism, Epidemiology Committee) ;
  • Lee, Young-Kyun (The Korean Society of Bone Metabolism, Epidemiology Committee) ;
  • Yoon, Hyun-Koo (The Korean Society of Bone Metabolism, Epidemiology Committee) ;
  • Shin, Chan-Soo (The Korean Society of Bone Metabolism, Epidemiology Committee) ;
  • Kim, Deog-Yoon (The Korean Society of Bone Metabolism, Epidemiology Committee) ;
  • Lee, Seong-Su (The Korean Society of Bone Metabolism, Epidemiology Committee) ;
  • Choi, Hyung-Jin (The Korean Society of Bone Metabolism, Epidemiology Committee) ;
  • Kim, Bom-Taeck (The Korean Society of Bone Metabolism, Epidemiology Committee) ;
  • Choi, Ji-Yeob (The Korean Society of Bone Metabolism, Epidemiology Committee)
  • 박찬미 (건강보험심사평가원) ;
  • 장선미 (건강보험심사평가원) ;
  • 장수현 (건강보험심사평가원) ;
  • 하용찬 (대한골대사학회 역학위원회) ;
  • 이영균 (대한골대사학회 역학위원회) ;
  • 윤현구 (대한골대사학회 역학위원회) ;
  • 신찬수 (대한골대사학회 역학위원회) ;
  • 김덕윤 (대한골대사학회 역학위원회) ;
  • 이성수 (대한골대사학회 역학위원회) ;
  • 최형진 (대한골대사학회 역학위원회) ;
  • 김범택 (대한골대사학회 역학위원회) ;
  • 최지엽 (대한골대사학회 역학위원회)
  • Published : 2010.12.31
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Abstract

Purpose: The aim of this study was to develop and validate identification criteria for the cases of osteoporotic hip fracture using the National Health Insurance Database, and we calculated the incidence rate of osteoporotic hip fracture in the Korean population using these criteria. Materials and Methods: The criteria to identify osteoporotic hip fracture using a diagnosis code, a procedure code, the type and number of medical service usages and the patients' ages were developed via discussions among experts. These criteria were validated by using a hip fracture cohort in which all the genuine osteoporotic hip fracture patients in the Jeju area were identified by reviewing the registered medical records and radiographs. By applying the identification criteria to the National Health Insurance Database that was accumulated until June 2009, we calculated the incidence rate of osteoporotic hip fracture in patients between 50 and 100 years of age in 2008. Results: The identification criteria had a sensitivity of 93.1% and a positive predictive value of 77.4%. A total of 20,432 osteoporotic hip fracture cases were identified in 2008, and the incidence rate was 15.7 cases per 10,000 persons. The osteoporotic hip fracture incidence rate for females was 20.7 (per 10,000persons), and this was 2.1 times higher than that for the males (9.8case per 10,000persons), and the rates were increased with age. Conclusion: The incidence of osteoporotic hip fracture that occurred on a nationwide scale can be more precisely estimated by using the National Health Insurance Database with its comprehensive information on the overall details of treatment as well as the diagnosis codes, and so the incidence of osteoporotic hip fracture can be reliably calculated for each year. The results from this research could be used as evidence in a hip fracture management plan for establishing Korean Health policy.

목적: 건강보험데이터베이스를 이용하여 전국적 규모의 골다공증성 고관절 골절 발생을 파악할 수 있는 기준을 정의하고 그 타당성을 평가한다. 또한 설정된 기준을 이용하여 골다공증성 고관절 골절의 발생률을 산출한다. 대상 및 방법: 골다공증성 고관절 골절의 발생률을 조사하기 위해 건강보험데이터베이스에서 ICD-10 코드를 이용한 진단명. 시술내역 등을 활용하여 골다공증성 고관절 골절의 식별기준을 개발하였다. 또한, 제주지역 전체를 대상으로 의무기록과 방사선사진을 검토하여 확인된 진성 골다공증성 고관절 골절 코호트를 이용하여 개발된 식별기준의 타당성을 평가하였다. 식별기준의 타당도는 민감도와 양성예측도로 평가하였다. 식별기준을 적용하여 2008년 50세 이상의 골다공증성 고관절 골절의 발생률을 산출하였다. 결과: 골다공증성 고관절 골절에 대한 식별기준의 민감도는 93.1%, 양성예측도는 77.4% 였다. 2008 년도 골다공증성 고관절 골절은 총 20,432건으로, 인구 1만명당 15.7건이 발생한 것으로 나타났다. 결론: 본 연구에서 개발한 식별기준은 향후 골다공증성 고관절 골절의 전국적 발생 규모의 추정을 위한 기초 자료가 되며, 이러한 결과는 고관절 골절 관리에 대한 정책방안을 수립하는데 근거 자료로 활용될 수 있다.

Keywords

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