Korea Journal of Hospital Management (한국병원경영학회지)

Korean Society of Hospital Management (한국병원경영학회)
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Analysis on the Relationship between the Number of Clinics and the Use of Preventable Hospital Service: focusing on asthma patients

지역 내 의원 수와 예방 가능한 병원 서비스 이용 간의 관계분석: 천식 환자를 중심으로

  • Lee, Hyun-Ji (Department of Health Administration, The Graduate School, Yonsei University) ;
  • Park, You-Hyun (Department of Health Administration, The Graduate School, Yonsei University) ;
  • Cho, Hyung-Kyung (Department of Health Administration, The Graduate School, Yonsei University) ;
  • Seol, Jin-Ju (Department of Health Administration, The Graduate School, Yonsei University) ;
  • Kwak, Jin-Mi (Department of Medical Information, Ansan University) ;
  • So, Ye-Kyeong (Department of Public Hospital Research and Policy Management, Seoul Health Foundation) ;
  • Park, Su-Jin (Department of Public Hospital Research and Policy Management, Seoul Health Foundation) ;
  • Lee, Kwang-Soo (Department of Health Administration, Yonsei University Mirae Campus)
  • 이현지 (연세대학교 대학원 보건행정학과) ;
  • 박유현 (연세대학교 대학원 보건행정학과) ;
  • 조형경 (연세대학교 대학원 보건행정학과) ;
  • 설진주 (연세대학교 대학원 보건행정학과) ;
  • 곽진미 (안산대학교 보건의료정보학과) ;
  • 소예경 (서울시 공공보건의료재단) ;
  • 박수진 (서울시 공공보건의료재단) ;
  • 이광수 (연세대학교 보건과학대학 보건행정학과)
  • Received : 2020.11.09
  • Accepted : 2020.12.21
  • Published : 2020.12.30
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Abstract

Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

Keywords

References

  1. Billings J, Zeitel L, Lukomnik J, Carey TS, Blank AE, Newman L. Impact of socioeconomic status on hospital use in new york city. Health affairs 1993;12(1):162-173.
  2. Gill JM. Can hospitalizations be avoided by having a regular source of care?. Family medicine 1997;29(3):166-171.
  3. Blustein J, Hanson K, & Shea S. Preventable hospitalizations and socioeconomic status: Failure to consider patients' characteristics may lead to the false conclusion that care is of poor quality. Health affairs 1998;17(2):177-189. https://doi.org/10.1377/hlthaff.17.2.177
  4. Laditka JN, Laditka SB, Probst JC. More may be better: evidence of a negative relationship between physician supply and hospitalization for ambulatory care sensitive conditions. Health services research 2005;40(4):1148-1166. https://doi.org/10.1111/j.1475-6773.2005.00403.x
  5. Rosano A, Loha CA, Falvo R, Zee JVD, Ricciardi W, Guasticchi G, et al. The relationship between avoidable hospitalization and accessibility to primary care: a systematic review. The European Journal of Public Health 2013;23(3):356-360. https://doi.org/10.1093/eurpub/cks053
  6. Das O. Korean Guideline for Asthma. The Korean Academy of Asthma. Allergy and Clinical immunology 2015;1-162.
  7. Braman SS. The global burden of asthma. Chest 2006;130(1):4S-12S. https://doi.org/10.1378/chest.130.1_suppl.4s
  8. Nunes C, Pereira AM, Morais-Almeida M, Asthma costs and social impact. Asthma Research and social impact 2017;3(1):1-11.
  9. Masoli M, Fabian D, Holt, S, Beasley R. The global burden of asthma. executive summary of the GINA Dissemination Committee report. Allergy 2004;59(5):469-478. https://doi.org/10.1111/j.1398-9995.2004.00526.x
  10. OECD. Health at a Glance 2017:OECD Indicators(Paris:OECD,2018),1-215.
  11. HIRA. 4th asthma adequacy evaluation result (Wonju:Health Insurance Review and Assessment service,2018,1-92.
  12. HIRA. 3th asthma adequacy evaluation result(Wonju:Health Insurance Review and Assessment service,2017)1-59.
  13. Shin SH. An Analysis of Clinical Trends of Asthma Patients in Korea. Policy Trends 2018;12(5):13.
  14. Caminal J, Starfield B, Sanchez E, Casanova C, Morales M. The role of primary care in preventing ambulatory care sensitive conditions. The European Journal of Public Health 2004;14(3):246-251. https://doi.org/10.1093/eurpub/14.3.246
  15. Ansari Z, Laditka JN, Laditka SB, Access to health care and hospitalization for ambulatory care sensitive conditions. Medical care research and review 2006;63(6):719-741. https://doi.org/10.1177/1077558706293637
  16. Wechsler ME, Managing asthma in primary care: putting new guideline recommendations into context. In Mayo Clinic Proceedings 2009;84(8):707-717.
  17. Cloutier MM, Hall CB, Wakefield DB, Bailit H, Use of asthma guidelines by primary care providers to reduce hospitalizations and emergency department visits in poor, minority, urban children. The Journal of pediatrics 2005;146(5):591-597. https://doi.org/10.1016/j.jpeds.2004.12.017
  18. Kim KS. Future Directions for the Heathcare Quality Assessment in NHI. Health and welfare policy forum 2013;8(202):48-60.
  19. Kwon UJ. Analysis of treatment trends for asthmatic patients over the past five years. Policy Trends 2019;13(4):56-65.
  20. Kim SH, Kim SH, Song WJ, Kwon JW, Kim MH, Kim KM, et al. Allergists' Perceptions and Practices on the Management of Chronic Cough in Korea: A Questionnaire Survey. The Korean Academy of Asthma, Alergy and Clinical Immunology 2012;32(4):239-253.
  21. Kline RB, Principles and practice of structural equation modeling 2nd edition(New York: Guilford publications,2005),1-366.
  22. Kang HC, Ko JY, Ha SL, Kim SW, Hong JS, Park JH, et al. The 2018 National Survey on Fertility and Family Health and Welfare. 2018;34:1-386.
  23. Yun MJ. Factors related to Asthma in Korean Adults: A Secondary Data Analysis of the Korea National Health and Nutrition Examination Survey from 2016. Korean Journal of Adult Nursing 2019;31(3):259-268. https://doi.org/10.7475/kjan.2019.31.3.259
  24. Kang HC, Kim SW, Ha SI, Kim SW, Seo EW. 2016 Korea Healthcare Quality Report Korea Institute for Health and Social Affairs. (Sejong:KIHSA,2016),1-488.
  25. Jo JJ. Community based Primary Care and Public health. Public Health Affairs, 2017;1(1):99-105. https://doi.org/10.29339/pha.1.1.99
  26. Kim NS, Park EJ, Jun JA, Kim DJ, Seo JH. Disease Management and Health Inequality: Current Status and Policy Recommendations. Health and welfare policy forum 2018(1):8-22.
  27. Jo JJ. Current Status of Commuity primary care pilot projects and policy implications. Research Institute for Healthcare Policy Korean Medical Association 2015;13(1):53-59.
  28. Kim NH. Introduction of chronic disease management projects and future development plans to strengthen community-centered primary care. Policy Trends 2018;12(5):18-27.
  29. Kim SY. Introduction of the Ministry of Health and Welfare's project to strengthen chronic disease management centered on neighborhood clinics (a pilot project for chronic disease management telephone counseling. Research Institute for Healthcare Policy Korean Medical Association. 2016;14(3):54-59.
  30. Lee JH. The Status and Major Issues of Primary Medical Care in Korea Based on OED Statistics. Policy Trends 2018;12(4):17-32.
  31. Jo HS. Strategies for improvement of primary care in Korea. Journal of the Korean Medical Association 2012;55(10):959-968. https://doi.org/10.5124/jkma.2012.55.10.959
  32. Fay JK, Jones A, Ram FS. Primary care based clinics for asthma. The Cochrane database of systematic reviews 2002;(1):CD003533.
  33. World Health Organization, World Health Organization Staff, & Swiatowa Organizacja Zdrowia. World report on knowledge for better health: strengthening health systems (Switzerland:World Health Organization,2004), 1-146.