S-Space College of Medicine/School of Medicine (의과대학/대학원) Health Policy and Management (의료관리학전공) Journal Papers (저널논문_의료관리학전공)
A spatial analysis of geographic variation and factors associated with hospitalization for bacterial pneumonia in Korea
- Issue Date
- BioMed Central
- BMC Pulmonary Medicine. 2019 Feb 20;19(1):45
- Pneumonia ; Bacterial pneumonia ; Hospitalization ; Geographic variation ; Spatial analysis ; Spatial regression ; Spatial autocorrelation ; Hospital bed supply ; Regional deprivation ; Primary care ; Korea
The incidence of pneumonia in Korea started to increase in the 1990s after a period of decrease and stabilization, and the mortality and hospitalization rates for pneumonia in Korea are alarmingly high. This study was performed to examine geographic variation and factors associated with hospitalization for bacterial pneumonia in Korea.
Data were acquired from the inpatient claims of the 2015 period of the National Health Insurance Service. The age- and sex-standardized hospitalization rates for bacterial pneumonia were calculated for three age groups. Geographic variation was measured with the coefficient of variation, the ratio of the 90th to the 10th percentile of the distribution of rates, and the systematic component of variation. Considering the results of Morans I statistic which suggested spatial autocorrelation, we estimated spatial regression models using spatial error models.
The hospitalization rate for bacterial pneumonia was 79.1 per 10,000 population, and the rate was the highest in the age group 0–14 at 325.3, and it was 161.5 among the elderly. The geographic variation statistics showed high variation with the coefficient variation at 0.6. The deprivation score showed positive associations, and the number of primary care physicians had a negative association with the hospitalization rates across all age groups but the age group 0–14. The number of beds in hospitals with less than 300 beds had a positive association with the hospitalization rates for bacterial pneumonia, and the impact was the strongest in the age group 0–14.
The present study shows that pneumonia can be a major public health issue even in a developed country. Socioeconomic conditions can still be a concern for pneumonia in developed countries, and the role of primary care physicians in preventing hospitalization for bacterial pneumonia needs to be recognized. Most of all, the strong impact of hospital beds on the hospitalization rates for pneumonia, especially for the children, should be addressed. High disease burden of pneumonia in Korea can partly be attributable to oversupply of hospital beds. These factors should be taken into consideration in establishing policy measures for the rise in pneumonia.