The impact of the COVID-19 pandemic on changes in medical service utilization - focusing on cancer, mild disease, and chronic disease -
Jo Hynu Sook Department of Health Care The Graduate School Yonsei University
Purpose: We aimed to analyze the impact of the COVID-19 pandemic on medical service utilization. Especially, we aimed to analyze to confirm changes in medical service utilization according to the patient’s economic level and disease type.
Methods: The data on claims for medical care benefits from the Health Insurance Review and Assessment Service were used, and the subjects of the study were patients who received outpatient treatment for cancer, mild, and chronic diseases from 2017 to 2022. General status and mean differences analysis between comparative groups were analyzed for three years before and after the COVID-19 pandemic, and the impact on the number of visits and prescriptions was verified by correcting gender, age, medical institution type, disease group (cancer, mild diseases, chronic diseases), and medical security types(health insurance, the next lowest class, first, second, others medical benefits) using interrupted ...
The impact of the COVID-19 pandemic on changes in medical service utilization - focusing on cancer, mild disease, and chronic disease -
Jo Hynu Sook Department of Health Care The Graduate School Yonsei University
Purpose: We aimed to analyze the impact of the COVID-19 pandemic on medical service utilization. Especially, we aimed to analyze to confirm changes in medical service utilization according to the patient’s economic level and disease type.
Methods: The data on claims for medical care benefits from the Health Insurance Review and Assessment Service were used, and the subjects of the study were patients who received outpatient treatment for cancer, mild, and chronic diseases from 2017 to 2022. General status and mean differences analysis between comparative groups were analyzed for three years before and after the COVID-19 pandemic, and the impact on the number of visits and prescriptions was verified by correcting gender, age, medical institution type, disease group (cancer, mild diseases, chronic diseases), and medical security types(health insurance, the next lowest class, first, second, others medical benefits) using interrupted time-series analysis, section regression analysis, and multiple regression analysis
Results: As a result of analyzing 2,713,958,516 statement of medical care benefit expenses from 2017 to 2022, COVID-19 affected changes medical service utilization. Due to outbreak of COVID-19, the number of days to visit decreased, and the number of days to prescribe increased relatively much, confirming a statistically significant difference The number of days of visits decreased relatively significantly in mild diseases(=-0.54, p<0.0001), cancer diseases and chronic diseases increased (=0.03, p=0.0008과 =0.08, p<0.0001), and the number of days of visits by type of medical security decreased (, health insurance: -0.10, the next lowest class: -0.14, first medical benefits: -0.16, second medical benefits: -0.18, other medical benefits: -0.20, p<0.0001) confirming statistically significant changes. The number of prescription days increased relatively significantly in mild diseases(=0.18, p<0.0001), cancer diseases and chronic diseases increased(=0.14, p=0.0001과 =0.11, p<0.0001), and both increased in analysis by type of medical security, confirming statistically significant changes.
Conclusions: Due to the outbreak of COVID-19, the number of visits to mild diseases in terms of disease-specific characteristics decreased, but contrary to expectations, the number of visits to cancer and chronic diseases did not decrease, so medical use disconnection was not observed. In the future, it is believed that in the era of infectious diseases such as COVID-19, it is necessary to monitor and manage the medical vulnerable. 목적 코로나19 대유행이 의료이용에 미친 영향을 분석하고자 한다. 특히 환자의 경제적 수준 및 질병유형에 따른 의료이용의 변화를 확인하고자 한다.
방법 건강보험심사평가원의 요양급여비용 청구자료를 활용하였고 연구대상은 2017년∼2022년까지 상급종합병원, 종합병원, 병원 및 의원에서 암질환, 경증질환, 만성질환으로 외래진료를 받은 환자로 하였다. 코로나19 유행 전·후 일반현황과 비교집단 간 평균차이분석을 수행하였고, 단절적 시계열 분석 및 구간별 회귀분석과 다중회귀분석으로 성별, 연령, 의료기관 종별, 지역, 질환군(암질환, 경증질환, 만성질환), 의료보장 유형(건강보험, 차상위, 의료급여 1종·2종·기타(행려·2종 장애인의 1차·2차 진료·노숙인 포함))을 보정하여 내원일수 및 처방일수에 미치는 영향을 검증하였다.
결과 2017년∼2022년까지 요양급여비용 청구명세서 2,713,958,516건을 분석한 결과 코로나19가 의료이용 변화에 영향을 주었다. 코로나19 발생으로 내원일수는 감소하였고, 처방일수는 큰 폭으로 증가하여 통계적으로 유의한 차이를 확인하였다. 내원일수는 경증질환에서 상대적으로 많이 감소(=-0.54, p<0.0001)하였고, 암질환과 만성질환은 각각 증가(=0.03, p=0.0008과 =0.08, p<0.0001)하였으며, 의료보장 유형별 분석에서 내원일수는 모두 감소(, 건강보험: -0.10, 차상위: -0.14, 의료급여 1종: -0.16, 의료급여 2종: -0.18, 의료급여 기타: -0.20, p<0.0001)하여 통계적으로 유의한 변화를 확인하였다. 특히, 의료급여에서 상대적으로 더 많이 감소한 것으로 확인된다. 처방일수는 경증질환에서 상대적으로 많이 증가(=0.18, p<0.0001)하였고. 하였고, 암질환과 만성질환은 각각 증가(=0.14, p=0.0001과 =0.11, p<0.0001)하였으며, 의료보장 유형별 분석에서 모두 증가(, 건강보험: 0.15, 차상위: 0.14, 의료급여 1종: 0.14, 의료급여 2종: 0.15, 의료급여 기타: 0.14, p<0.0001)하여 통계적으로 유의한 변화를 확인하였다.
결론 코로나19 발생은 질환별 특성의 경우 경증질환은 내원일수가 감소하였으나 예상과 다르게 암질환과 만성질환은 내원일수가 감소하지 않아 의료이용 단절이 관찰되지 않았으며, 의료취약 계층의 경우 내원일수가 점진적으로 증가한 것이 관찰되었다. 향후 코로나19와 같은 감염병 시대에서는 의료취약 계층에 대한 감시 및 관리가 필요 할 것으로 사료된다.
The impact of the COVID-19 pandemic on changes in medical service utilization - focusing on cancer, mild disease, and chronic disease -
Jo Hynu Sook Department of Health Care The Graduate School Yonsei University
Purpose: We aimed to analyze the impact of the COVID-19 pandemic on medical service utilization. Especially, we aimed to analyze to confirm changes in medical service utilization according to the patient’s economic level and disease type.
Methods: The data on claims for medical care benefits from the Health Insurance Review and Assessment Service were used, and the subjects of the study were patients who received outpatient treatment for cancer, mild, and chronic diseases from 2017 to 2022. General status and mean differences analysis between comparative groups were analyzed for three years before and after the COVID-19 pandemic, and the impact on the number of visits and prescriptions was verified by correcting gender, age, medical institution type, disease group (cancer, mild diseases, chronic diseases), and medical security types(health insurance, the next lowest class, first, second, others medical benefits) using interrupted time-series analysis, section regression analysis, and multiple regression analysis
Results: As a result of analyzing 2,713,958,516 statement of medical care benefit expenses from 2017 to 2022, COVID-19 affected changes medical service utilization. Due to outbreak of COVID-19, the number of days to visit decreased, and the number of days to prescribe increased relatively much, confirming a statistically significant difference The number of days of visits decreased relatively significantly in mild diseases(=-0.54, p<0.0001), cancer diseases and chronic diseases increased (=0.03, p=0.0008과 =0.08, p<0.0001), and the number of days of visits by type of medical security decreased (, health insurance: -0.10, the next lowest class: -0.14, first medical benefits: -0.16, second medical benefits: -0.18, other medical benefits: -0.20, p<0.0001) confirming statistically significant changes. The number of prescription days increased relatively significantly in mild diseases(=0.18, p<0.0001), cancer diseases and chronic diseases increased(=0.14, p=0.0001과 =0.11, p<0.0001), and both increased in analysis by type of medical security, confirming statistically significant changes.
Conclusions: Due to the outbreak of COVID-19, the number of visits to mild diseases in terms of disease-specific characteristics decreased, but contrary to expectations, the number of visits to cancer and chronic diseases did not decrease, so medical use disconnection was not observed. In the future, it is believed that in the era of infectious diseases such as COVID-19, it is necessary to monitor and manage the medical vulnerable. 목적 코로나19 대유행이 의료이용에 미친 영향을 분석하고자 한다. 특히 환자의 경제적 수준 및 질병유형에 따른 의료이용의 변화를 확인하고자 한다.
방법 건강보험심사평가원의 요양급여비용 청구자료를 활용하였고 연구대상은 2017년∼2022년까지 상급종합병원, 종합병원, 병원 및 의원에서 암질환, 경증질환, 만성질환으로 외래진료를 받은 환자로 하였다. 코로나19 유행 전·후 일반현황과 비교집단 간 평균차이분석을 수행하였고, 단절적 시계열 분석 및 구간별 회귀분석과 다중회귀분석으로 성별, 연령, 의료기관 종별, 지역, 질환군(암질환, 경증질환, 만성질환), 의료보장 유형(건강보험, 차상위, 의료급여 1종·2종·기타(행려·2종 장애인의 1차·2차 진료·노숙인 포함))을 보정하여 내원일수 및 처방일수에 미치는 영향을 검증하였다.
결과 2017년∼2022년까지 요양급여비용 청구명세서 2,713,958,516건을 분석한 결과 코로나19가 의료이용 변화에 영향을 주었다. 코로나19 발생으로 내원일수는 감소하였고, 처방일수는 큰 폭으로 증가하여 통계적으로 유의한 차이를 확인하였다. 내원일수는 경증질환에서 상대적으로 많이 감소(=-0.54, p<0.0001)하였고, 암질환과 만성질환은 각각 증가(=0.03, p=0.0008과 =0.08, p<0.0001)하였으며, 의료보장 유형별 분석에서 내원일수는 모두 감소(, 건강보험: -0.10, 차상위: -0.14, 의료급여 1종: -0.16, 의료급여 2종: -0.18, 의료급여 기타: -0.20, p<0.0001)하여 통계적으로 유의한 변화를 확인하였다. 특히, 의료급여에서 상대적으로 더 많이 감소한 것으로 확인된다. 처방일수는 경증질환에서 상대적으로 많이 증가(=0.18, p<0.0001)하였고. 하였고, 암질환과 만성질환은 각각 증가(=0.14, p=0.0001과 =0.11, p<0.0001)하였으며, 의료보장 유형별 분석에서 모두 증가(, 건강보험: 0.15, 차상위: 0.14, 의료급여 1종: 0.14, 의료급여 2종: 0.15, 의료급여 기타: 0.14, p<0.0001)하여 통계적으로 유의한 변화를 확인하였다.
결론 코로나19 발생은 질환별 특성의 경우 경증질환은 내원일수가 감소하였으나 예상과 다르게 암질환과 만성질환은 내원일수가 감소하지 않아 의료이용 단절이 관찰되지 않았으며, 의료취약 계층의 경우 내원일수가 점진적으로 증가한 것이 관찰되었다. 향후 코로나19와 같은 감염병 시대에서는 의료취약 계층에 대한 감시 및 관리가 필요 할 것으로 사료된다.
Keyword
#코로나19 내원일수 의료이용 COVID-19 days of visits days of prescription medical service utilization
학위논문 정보
저자
조현숙
학위수여기관
연세대학교 대학원
학위구분
국내석사
학과
보건의료학협동과정
지도교수
정재흥
발행연도
2023
총페이지
vi, 73장
키워드
코로나19 내원일수 의료이용 COVID-19 days of visits days of prescription medical service utilization
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