Aims of Study
Benign prostatic hyperplasia (BPH) is defined clinically as a condition that is characterized by the combination of an enlarged prostate and lower urinary tract symptoms (LUTS). As for surgical treatment, transurethral resection of the prostate (TURP) was gold standard, but laser p...
Aims of Study
Benign prostatic hyperplasia (BPH) is defined clinically as a condition that is characterized by the combination of an enlarged prostate and lower urinary tract symptoms (LUTS). As for surgical treatment, transurethral resection of the prostate (TURP) was gold standard, but laser prostatectomy showed comparable results to conventional TURP. But there is few recently published data of whole national-wide investigation about surgical treatment of BPH. Meanwhile, the healthcare system in Korea is implemented under the National Health Insurance program, which is compulsory by law and covers 47 million out of the South Korean population of 51 million as a universal social insurance program. This system is operated by a single insurer, the National Health Insurance Service, under the supervision of the Korean government, and all national health insurance claims data are required to be filed to the health insurance review and assessment service (HIRA) for reimbursement. The aim of this study is to investigate the present status related BPH surgery in Korea by obtaining HIRA claims data.
Materials and Methods
This study utilized data from Nationwide HIRA from the 2010 dataset, which is made available to researchers for research on an annual basis. These data were performed with a complex, stratified, multistage cluster survey of a representative Korean population one year and above. These were assessed by age, geographic distribution, assort classification of hospital and sort of each surgical technique.
Age was classified into < 40 years, 10 year intervals for ≥ 40 years (30-39, 40-49, 50-59, 60-69, 70-79, over 80), geographical distribution into seven metropolises, including Seoul, and nine provinces by administrative divisions of Korea, and medical institution into 4 types: tertiary hospital, general hospital, hospital and clinic. Also, three kinds of surgeries were included in our data: TURP, Potassium titanyl phosphate laser vaporisation ot the prostate (KTP) and holmium laser enucleation of the prostate (HOLEP).
Frequency for sociodemographic characteristics and treatments are presented for the patients through statistical analysis. The number of each surgical case and the number of patients received BPH related surgery were analyzed, respectively. Relative risks of the surgical cases were estimated by year and age from each surgical modality.
Results
There are not many changes of total number of BPH related surgery during five years. The most commonly used surgical option was TURP through 5 years and there is not much alteration in the number of that while the number of HOLEP is dramatically increased. The number of HOLEP overtook the number of KTP laser after 2011.
According to the analysis by age distribution, the number of patient receiving BPH surgery were high in sixties until 2011, however the number was highest in seventies from 2012. Poisson’s regression analysis showed that TURP and KTP were generally decreased through years while HOLEP was increasing.
Regarding medical institutions, the total number of BPH related surgery is increased in tertiary general hospital and general hospital continuously whereas it was dramatically decreased in hospital. In clinics, the number was slightly decreased through years. In all kinds of hospitals, the rate of HOLEP were increased.
According to the geographical distribution, the number of the BPH surgery was greater in metropolitan cities compared to non metropolitan cities. The tendency to increases of HOLEP surgery was also greater in large cities.
Conclusions
Through the data of the National Health Insurance Service, the present status of BPH related surgery in Korea was known the total number of BPH related surgery in Korea was not altered through years. However, the number of operations varied greatly the number of TURPs was similar, while that of KTP was significantly reduced, and that of the HOLEP was increasing. In geographically, the surgery was concentrated in Seoul and Gyeongi province. The tendency of increasing HOLEP was common throughout the country. The current trend about the BPH surgery in Korea through the data analysis of NHIS seems valuable for academic and social economic references as well.
Aims of Study
Benign prostatic hyperplasia (BPH) is defined clinically as a condition that is characterized by the combination of an enlarged prostate and lower urinary tract symptoms (LUTS). As for surgical treatment, transurethral resection of the prostate (TURP) was gold standard, but laser prostatectomy showed comparable results to conventional TURP. But there is few recently published data of whole national-wide investigation about surgical treatment of BPH. Meanwhile, the healthcare system in Korea is implemented under the National Health Insurance program, which is compulsory by law and covers 47 million out of the South Korean population of 51 million as a universal social insurance program. This system is operated by a single insurer, the National Health Insurance Service, under the supervision of the Korean government, and all national health insurance claims data are required to be filed to the health insurance review and assessment service (HIRA) for reimbursement. The aim of this study is to investigate the present status related BPH surgery in Korea by obtaining HIRA claims data.
Materials and Methods
This study utilized data from Nationwide HIRA from the 2010 dataset, which is made available to researchers for research on an annual basis. These data were performed with a complex, stratified, multistage cluster survey of a representative Korean population one year and above. These were assessed by age, geographic distribution, assort classification of hospital and sort of each surgical technique.
Age was classified into < 40 years, 10 year intervals for ≥ 40 years (30-39, 40-49, 50-59, 60-69, 70-79, over 80), geographical distribution into seven metropolises, including Seoul, and nine provinces by administrative divisions of Korea, and medical institution into 4 types: tertiary hospital, general hospital, hospital and clinic. Also, three kinds of surgeries were included in our data: TURP, Potassium titanyl phosphate laser vaporisation ot the prostate (KTP) and holmium laser enucleation of the prostate (HOLEP).
Frequency for sociodemographic characteristics and treatments are presented for the patients through statistical analysis. The number of each surgical case and the number of patients received BPH related surgery were analyzed, respectively. Relative risks of the surgical cases were estimated by year and age from each surgical modality.
Results
There are not many changes of total number of BPH related surgery during five years. The most commonly used surgical option was TURP through 5 years and there is not much alteration in the number of that while the number of HOLEP is dramatically increased. The number of HOLEP overtook the number of KTP laser after 2011.
According to the analysis by age distribution, the number of patient receiving BPH surgery were high in sixties until 2011, however the number was highest in seventies from 2012. Poisson’s regression analysis showed that TURP and KTP were generally decreased through years while HOLEP was increasing.
Regarding medical institutions, the total number of BPH related surgery is increased in tertiary general hospital and general hospital continuously whereas it was dramatically decreased in hospital. In clinics, the number was slightly decreased through years. In all kinds of hospitals, the rate of HOLEP were increased.
According to the geographical distribution, the number of the BPH surgery was greater in metropolitan cities compared to non metropolitan cities. The tendency to increases of HOLEP surgery was also greater in large cities.
Conclusions
Through the data of the National Health Insurance Service, the present status of BPH related surgery in Korea was known the total number of BPH related surgery in Korea was not altered through years. However, the number of operations varied greatly the number of TURPs was similar, while that of KTP was significantly reduced, and that of the HOLEP was increasing. In geographically, the surgery was concentrated in Seoul and Gyeongi province. The tendency of increasing HOLEP was common throughout the country. The current trend about the BPH surgery in Korea through the data analysis of NHIS seems valuable for academic and social economic references as well.
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