[논문]고령화연구패널조사 2014-2018년 데이터를 이용한 한국 노인의 복합만성질환 변화와 본인부담 총 의료비의 연관성

박수진; 남진영

doi:10.4332/kjhpa.2022.32.3.282

[국내논문] 고령화연구패널조사 2014-2018년 데이터를 이용한 한국 노인의 복합만성질환 변화와 본인부담 총 의료비의 연관성
Association between Changes in Multiple Chronic Conditions and Health Expenditures among Elderly in South Korea: Korean Longitudinal Study of Aging 2014-2018 원문보기

Health policy and management = 보건행정학회지, v.32 no.3, 2022년, pp.282 - 292

박수진 (을지대학교 일반대학원 의료경영학과) , 남진영 (을지대학교 의료경영학과)

Abstract ▼ AI-Helper

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

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표/그림 (4)

그림 Figure 1. Flow chart representing the selected study population. From Park S, et al. Healthcare (Basel) 2022;10(4):742 [17]. K-MMSE, Korean version of Mini-Mental Sate Examination.
표 Table 1. Differences in total medical cost according to the characteristics of study population (unit: thousand won)
표 Table 2. The association between the change of MCC and total medical cost
표 Table 3. The association between the change of MCC and total medical cost by cognitive function

참고문헌 (36)

Jeon HS. An exploratory study on the predictors of cognitive improvement among older adults: using Korean Longitudinal Study of Aging(KLoSA). Health Soc Welf Rev 2013;33(2):461-488. DOI: https://doi.org/10.15709/hswr.2013.33.2.461.
Park H, Ha J. Prediction models of mild cognitive impairment using the Korea Longitudinal Study of Ageing. J Korean Acad Nurs 2020;50(2):191-199. DOI: https://doi.org/10.4040/jkan.2020.50.2.191.

원문보기 상세보기
Lee SY. Development of a sustainable health management system for management of chronic diseases. Health Welf Policy Forum 2004; 87):72-81. DOI: https://doi.org/10.23062/2004.01.7.
Cho K. Current status of non-communicable diseases in the Republic of Korea. Public Health Wkly Rep 2021;14(4):166-177.
Statistics Korea. 2020 Population projections for Korea [Internet]. Daejeon: Statistics Korea; 2021 [cited 2021 Sep 19]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId101&tblIdDT_1SHE10Rconn_pathI2.
van den Akker M, Buntinx F, Metsemakers JF, Roos S, Knottnerus JA. Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 1998;51(5):367-375. DOI: https://doi.org/10.1016/s0895-356(97)00306-5.

상세보기
Park B, Ock M, Lee HA, Lee S, Han H, Jo MW, et al. Multimorbidity and health-related quality of life in Koreans aged 50 or older using KNHANES 2013-2014. Health Qual Life Outcomes 2018;16(1):186. DOI: https://doi.org/10.1186/s12955-018-1016-6.

상세보기
Park EJ, Bae JE, Song ES, Jung Y, Choi SG, Lee EJ, et al. 2018 Korea medical panel basic analysis report (II): disease morbidity, chronic diseases, health behaviors and health levels. Sejong: Korea Institute of Health and Social Research; 2020.
Bahler C, Huber CA, Brungger B, Reich O. Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. BMC Health Serv Res 2015;15:23. DOI: https://doi.org/10.1186/s12913-015-0698-2.

상세보기
Seo JH. An analysis for the multimorbidity patterns and healthcare cost using the Korea Health Panel Survey. Health Welf Policy Forum 2021;(302):17-28. DOI: https://doi.org/10.23062/2021.12.3.
Klompstra L, Ekdahl AW, Krevers B, Milberg A, Eckerblad J. Factors related to health-related quality of life in older people with multimorbidity and high health care consumption over a two-year period. BMC Geriatr 2019;19(1):187. DOI: https://doi.org/10.1186/s12877-019-1194-z.

상세보기
Lee Y, Cho CC. Examining the effects of multiple chronic conditions on cognitive decline and potential moderators among older Koreans: findings from the Korean Longitudinal Study of Ageing 2006-2016. Arch Gerontol Geriatr 2021;95:104424. DOI: https://doi.org/10.1016/j.archger.2021.104424.

상세보기
Falvey JR, Gustavson AM, Price L, Papazian L, Stevens-Lapsley JE. Dementia, comorbidity, and physical function in the program of all-inclusive care for the elderly. J Geriatr Phys Ther 2019;42(2): E1-E6. DOI: https://doi.org/10.1519/JPT.0000000000000131.

상세보기
Hajat C, Stein E. The global burden of multiple chronic conditions: a narrative review. Prev Med Rep 2018;12:284-293. DOI: https://doi.org/10.1016/j.pmedr.2018.10.008.

상세보기
Park B, Park J, Jun JK. Cognitive impairment, depression, comorbidity of the two and associated factors among the early sixties in a rural Korean community. PLoS One 2013;8(11):e79460. DOI: https://doi.org/10.1371/journal.pone.0079460.

상세보기
Petersen RC. Mild Cognitive Impairment. Continuum (Minneap Minn) 2016;22(2 Dementia):404-418. DOI: https://doi.org/10.1212/CON.0000000000000313.

상세보기
Park S, Nam JY. Effects of changes in multiple chronic conditions on medical costs among older adults in South Korea. Healthcare (Basel) 2022;10(4):742. DOI: https://doi.org/10.3390/healthcare10040742.

상세보기
Kang Y, NA DL, Hahn S. A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. J Korean Neurol Assoc 1997;15(2):300-308.
Cortaredona S, Ventelou B. The extra cost of comorbidity: multiple illnesses and the economic burden of non-communicable diseases. BMC Med 2017;15(1):216. DOI: https://doi.org/10.1186/s12916-017-0978-2.

상세보기
Buja A, Claus M, Perin L, Rivera M, Corti MC, Avossa F, et al. Multimorbidity patterns in high-need, high-cost elderly patients. PLoS One 2018;13(12):e0208875. DOI: https://doi.org/10.1371/journal.pone.0208875.

상세보기
Park SB, Kim YS, Cho KH, Lee SH, Choi YE, Han GT. et al. Development of a management system model through medical use of patients with multiple chronic diseases [Internet]. Goyang: Health Insurance Service Ilsan Hospital; 2017 [cited 2021 Sep 19]. Available from: https://www.nhimc.or.kr/lab/info/labNewFileDown.do?BCode571&SeqNo60.
Aspden P, Wolcott JA, Bootman JL, Cronenwett LR. Preventing medication errors. Washington (DC): The National Academies Press; 2007. DOI: https://doi.org/10.17226/11623.
Khezrian M, McNeil CJ, Murray AD, Myint PK. An overview of prevalence, determinants and health outcomes of polypharmacy. Ther Adv Drug Saf 2020;11:2042098620933741. DOI: https://doi. org/10.1177/2042098620933741.

상세보기
Kang SH, Ko E. Factors associated with medication adherence among the elderly with chronic diseases. Korean J Adult Nurs 2021;33(2):189-201. DOI: https://doi.org/10.7475/kjan.2021.33.2.189.

상세보기
Unutmaz GD, Soysal P, Tuven B, Isik AT. Costs of medication in older patients: before and after comprehensive geriatric assessment. Clin Interv Aging 2018;13:607-613. DOI: https://doi.org/10.2147/CIA.S159966.

상세보기
Michalowsky B, Eichler T, Thyrian JR, Hertel J, Wucherer D, Laufs S, et al. Medication cost of persons with dementia in primary care in Germany. J Alzheimers Dis 2014;42(3):949-958. DOI: https://doi.org/10.3233/JAD-140804.

상세보기
Vassilaki M, Aakre JA, Cha RH, Kremers WK, St Sauver JL, Mielke MM, et al. Multimorbidity and risk of mild cognitive impairment. J Am Geriatr Soc 2015;63(9):1783-1790. DOI: https://doi.org/10.1111/jgs.13612.

상세보기
Kerti L, Witte AV, Winkler A, Grittner U, Rujescu D, Floel A. Higher glucose levels associated with lower memory and reduced hippocampal microstructure. Neurology 2013;81(20):1746-1752. DOI: https://doi.org/10.1212/01.wnl.0000435561.00234.ee.

상세보기
McGrath ER, Beiser AS, DeCarli C, Plourde KL, Vasan RS, Greenberg SM, et al. Blood pressure from mid- to late life and risk of incident dementia. Neurology 2017;89(24):2447-2454. DOI: https://doi.org/10.1212/WNL.0000000000004741.

상세보기
Leibson CL, Long KH, Ransom JE, Roberts RO, Hass SL, Duhig AM, et al. Direct medical costs and source of cost differences across the spectrum of cognitive decline: a population-based study. Alzheimers Dement 2015;11(8):917-932. DOI: https://doi.org/10.1016/j.jalz.2015.01.007.

상세보기
Abad-Diez JM, Calderon-Larranaga A, Poncel-Falco A, PobladorPlou B, Calderon-Meza JM, Sicras-Mainar A, et al. Age and gender differences in the prevalence and patterns of multimorbidity in the older population. BMC Geriatr 2014;14:75. DOI: https://doi.org/10.1186/1471-2318-14-75.

상세보기
Ho V, Chen C, Ho S, Hooi B, Chin LS, Merchant RA. Healthcare utilisation in the last year of life in internal medicine, young-old versus old-old. BMC Geriatr 2020;20(1):495. DOI: https://doi.org/10.1186/s12877-020-01894-0.

상세보기
Yoon YS, Jung B, Kim D, Ha IH. Factors underlying unmet medical needs: a cross-sectional study. Int J Environ Res Public Health 2019;16(13):2391. DOI: https://doi.org/10.3390/ijerph16132391.

상세보기
Ko JA, Kim JL, Kim HS, Park JH, Chae JM. Analysis of health care services in elderly populations and future prospects. Wonju: Health Insurance Review and Assessment Service; 2019.
Milani SA, Crooke H, Cottler LB, Striley CW. Sex differences in frequent ED use among those with multimorbid chronic diseases. Am J Emerg Med 2016;34(11):2127-2131. DOI: https://doi.org/10.1016/j.ajem.2016.07.059.

상세보기
Sathya T, Nagarajan R, Selvamani Y. Multimorbidity as a risk factor of elder abuse/mistreatment in India: a cross-sectional study. J Interpers Violence 2022;37(11-12):NP9191-NP9213. DOI: https://doi.org/10.1177/0886260520980391.

상세보기

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동의어: Packet Collision Rate

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