Patients with respiratory diseases are increasing as air pollution due to fine dust gets worse. Diseases that occupy a large proportion of respiratory diseases in medical institutions are acute bronchitis, chronic bronchitis and Allergic rhinitis. The number of patients with all three diseases is gradually increasing. This study was to suggest assignment of medicine policy for improving accessibility to Korean medical treatment of respiratory diseases analyzing the current treatment status of acute bronchitis, Chronic bronchitis and Allergic rhinitis patients in Western medical and Korean medical institutes in this situation.
Methods
This study used 2017 National patient sample data from the Korean Health Insurance Review and Assessment Service for research. Acute bronchitis, Chronic bronchitis, Allergic rhinitis was according to KCD code. This research contains Socio-demographic analysis classified by sex and age, the number of three disease’s patients. Also the number of medical treatment, the expense of recuperation cost, medical practices were analyzed compare with Western and Korean medicine.
Results
The incidence of three diseases is higher among female than male. There are many patients under the age of 10 in the case of acute bronchitis and allergic rhinitis, while there are many patients over 50 years of age in chronic bronchitis. Western medical treatment take up a larger proportion than Korean medical treatment in part of the number of three disease’s patients, the number of medical treatment, the expense of recuperation cost.
Conclusions
Much more patients of these diseases visit in Western medical clinic and hospital than Korean medical clinic and hospital for treatment. There are many parts of Korean medical treatment that are not covered by Health insurance benefits like herbal decoction, pharmacopuncture, etc. Korean medicine need to do the efforts for expanding medical field in variety. Also it is demanded for institutional support for reduction of the cost burden and improving on accessibility of Korean medical treatment in order to treat with the increase in respiratory diseases due to fine dust.
Number of Acute bronchitis, Chronic bronchitis and Allergic rhinitis patients in recent 6 years(2013–2018).
a) Number of Acute bronchitis patients in medical treatment. b) Number of Acute bronchitis patients in Korean medical treatment. c) Number of Chronic bronchitis patients in medical treatment d) Number of Chronic bronchitis patients in Korean medical treatment. e) Number of Allergic rhinitis patients in medical treatment. f) Number of Allergic rhinitis patients in Korean medical treatment.
Fig. 2
Percentage of Acute bronchitis, Chronic bronchitis and Allergic rhinitis patients by sex.
Fig. 3
Percentage of Acute bronchitis, Chronic bronchitis and Allergic rhinitis patients by age.
Table 1
The whole number of patients of Acute bronchitis, Chronic bronchitis and Allergic rhinitis.
Acute bronchitis
Chronic bronchitis
Allergic rhinitis
Number of Patients
Total(n)
Sex
Total(n)
Sex
Total(n)
Sex
485,004
M
F
100,148
M
F
193,448
M
F
216,905
268,099
43,901
56,247
90,179
103,269
%
100
44.7
55.3
100
43.8
56.2
100
46.6
53.4
Table 2
Number of medical treatments of Acute bronchitis, Chronic bronchitis and Allergic rhinitis.
Number of medical treatments
Acute bronchitis
Chronic bronchitis
Allergic rhinitis
N
%
N
%
N
%
Total
1,670,946
100
215,584
100
473,205
100
Western Medical Inpatients
3,123
0.19
1,373
0.64
182
0.04
Western Medical Outpatient
1,665,006
99.64
211,158
97.95
451,901
95.50
Korean Medical Inpatients
2
0.00
9
0.00
0
0
Korean Medical Outpatient
394
0.02
634
0.29
19,432
4.11
The others
2,421
0.14
2,410
1.12
1,690
0.36
Table 3
Western Medical treatment expense of Acute bronchitis, Chronic bronchitis and Allergic rhinitis.
Classification
Total expense (unit:1000won)
Expense-per-patient (unit:won)
Expense-per-treatment (unit:won)
Acute bronchitis
W.Medical Inpatient
26,760,871
1,910,377
1,741,456
611,712
W.Medical Outpatients
24,825,946
51,429
14,910
K.Medical Inpatient
219
219,000
109,500
K.Medical Outpatients
7,601
88,384
19,292
The others
16,728
15,305
6,910
Chronic bronchitis
W.Medical Inpatient
5,163,516
1,269,248
1,482,767
924,434
W.Medical Outpatients
3,861,106
39,337
18,285
K.Medical Inpatient
2,004
1,002,000
222,667
K.Medical Outpatients
13,128
75,017
20,707
The others
18,030
18,801
7,481
Allergic rhinitis
W.Medical Inpatient
7,775,790
66,057
623,179
362,951
W.Medical Outpatients
7,283,249
38,428
16,117
K.Medical Inpatient
0
0
0
K.Medical Outpatients
412,296
132,104
21,217
The others
14,188
20,473
8,395
Table 4
Western and Korean Medical treatment for Acute bronchitis.
Acute bronchitis Medical treatment Classification
%
Acute bronchitis Korean medical treatment Classification
Western and Korean Medical treatment for Chronic bronchitis
Allergic rhinitis Medical treatment Classification
%
Allergic rhinitis Korean medical treatment Classification
%
Consultation fee(Revisit): Medical in clinic
27.4
Consultation fee(Revisit)
22.6
Consultation fee(initial): Medical in clinic
19.5
Meridian Acupuncture(Over 2 Acupoints)
14.5
Medication
15.6
Indirect Moxibustion/ Device
8.8
Outpatient Pharmaceutical fee [per 1day]: Clinic
6.6
Syndrome Differentiation fee
8
Injection fee/ Hypodermic, Intramuscular
6.4
Cupping therapy(Dry Cupping)/moving cupping
4.7
Upper respiratory steam inhalation treatment
4.8
Joined Puncture
4.6
Consultation fee(Revisit): Medical in hospital
2.5
Consultation fee(Initial)
4.4
Consultation fee(initial): Medical in hospital
1
Indirect Moxibustion/ Mugwort
3.3
Infrared therapy [per 1day]
1
Meridian Acupuncture(1 Acupoint)
3.2
Consultation fee(Revisit): General Hospital
0.8
Infrared Therapy
3.2
NasoPharyngoscopy
0.8
Acupucture in Nasal cavity
3.1
Table 6
Western and Korean Medical treatment for Allergic rhinitis
Allergic rhinitis Medical treatment Classification
%
Allergic rhinitis Korean medical treatment Classification
%
Consultation fee(Revisit): Medical in clinic
27.4
Consultation fee(Revisit)
22.6
Consultation fee(initial): Medical in clinic
19.5
Meridian Acupuncture(Over 2 Acupoints)
14.5
Medication
15.6
Indirect Moxibustion/ Device
8.8
Outpatient Pharmaceutical fee [per 1day]: Clinic
6.6
Syndrome Differentiation fee
8
Injection fee/ Hypodermic, Intramuscular
6.4
Cupping therapy(Dry Cupping)/moving cupping
4.7
Upper respiratory steam inhalation treatment
4.8
Joined Puncture
4.6
Consultation fee(Revisit): Medical in hospital
2.5
Consultation fee(Initial)
4.4
Consultation fee(initial): Medical in hospital
1
Indirect Moxibustion/ Mugwort
3.3
Infrared therapy [per 1day]
1
Meridian Acupuncture(1 Acupoint)
3.2
Consultation fee(Revisit): General Hospital
0.8
Infrared Therapy
3.2
NasoPharyngoscopy
0.8
Acupucture in Nasal cavity
3.1
참고문헌
1. World Health Organization. Air pollution including WHO’s 1999 guidelines for air pollution control. Geneva. World Health Organization;(2000.
2. 질병관리본부. 대기오염에 대한 건강피해 연계 성 연구. (2015.
4. Niroumand, M, & Grossman, RF. Air way infection. Infectious Disease Clinics of North America J, (1998). 12(3), 67188.
5. McCaig, LF, & Hughes, JM. Trends in antimicrobial drug prescribing among office-based physicians in t he United States. JAMA, (1995). 273(3), 214.
6. Lyu, YR, Park, SJ, Lee, EJ, Jeon, JH, Jung, IC, & Park, YC. A Systemic Review of Clinical Trials Using Medication for Acute Bronchitis: A Pre-study on the Development of Traditional Korean Medicine Clinical Practice Guideline. Korean Med J, (2017). 38(1), 93-111.
8. 연세대학교 의과대학 진단방사선학교실 편저. 진단 방사선학. 서울. 고려의학;(1998). p. 83
9. Anthonisen, NR, Manfreda, J, Warren, CP, Hershfield, ES, Harding, GK, & Nelson, NA. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med, (1987). 106(2), 196-204.
10. 한용철 . 임상호흡기학. 서울:일조각. 1998. 226-232.
11. Hong CE. Textbook of pediatrics. 10th ed. Seoul. Miraen Co;(2012). p. 1144-1150.
12. Kim KB, Kim DG, Kim YH, Kim JH, Min SY, Park EJ, et al. Pediatrics of Korean medicine. Seoul. Eui Seong Dang Publishing Co;(2010). p. 745-750.
13. Kim, CW. Current Update on Allergic Rhinitis. Korean J Med, (2012). 82(3), 298-303.
14. Koh, YI. Clinical Practice Guideline for Physicians on Allergic Rhinitis. Korean J Med, (2017). 92(5), 429-436.
17. Pope, CA, Ezzati, M, & Dockery, DW. Fine-particulate air pollution and life expectancy in the United States. N Engl J Med, (2009). 360, 376-386.
18. Samet, JM, Dominici, F, Curriero, FC, Coursac, I, & Zeger, SL. Fine Particulate Air Pollution and Mortality in 20 U.S. Cities, 1987–1994. N Engl J Med, (2000). 343(24), 1742-1749.
19. Hong, YC, Lee, JT, Kim, H, Ha, EH, Schwartz, J, & Christiani, DC. Effects of air pollutants on acute stroke mortality. Environmental Health Perspectives, (2002). 110(2), 187-191.
20. Xiong, Q, Zhao, W, Gong, Z, Zhao, W, & Tang, T. Fine Particulate Matter Pollution and Hospital Admissions for Respiratory Diseases in Beijing, China. Int J Environ Res Public Health, (2015). 12(9), 11880-11892.
21. Kim, JH, Oh, SK, Seong, HU, Lim, DH, Son, BK, Kim, HC, Lee, JY, & Leem, JH. Relationship Between Air Pollutants and Prevalence of Allergic Disease/Pulmonary Function in Students in Incheon. Pediatric allergy and respiratory disease, (2010). 20(4), 264-276.
22. Baek, HJ, Bhang, YH, Kim, JH, Kim, SJ, Kim, KI, Lee, BJ, Jung, HJ, & Jung, SK. A Retrospective Clinical Analysis of Chronic Obstructive Pulmonary Disease (COPD) Outpatients Who Presented To a Korean Medicine Hospital: Symptoms and Treatment Effects. J Int Korean Med, (2016). 37(4), 624-63.
23. Shin, MG, Kim, HS, Heo, WY, Kim, BJ, & Gang, IA. The Effect of Cervi Pantotrichum Cornu Pharmacopuncture at Pyesu(BL13) on Chronic cough: Report of Six Cases. The Acupuncture, (2013). 30(5), 253-262.
24. Koo, EJ, Han, JK, & Kim, YH. Review of Clinical Studies on Korean Medicine and Complementary and Alternative Medicine Treatment for Allergic Rhinitis in the Korean Literature. J Pediatr Korean Med, (2015). 29(4), 77-89.