Analysis of medical service utilization for post-stroke sequelae in Korea between 2016 and 2018: a cross-sectional study

Abstract

In this retrospective cross-sectional observational study, the medical service utilization of post-stroke sequelae patients was examined using a national patient sample. The Korean Health Insurance Review and Assessment Service-National Patients Sample database was used to investigate the medical service utilization of 19,562 patients, diagnosed with post-stroke sequelae of cerebrovascular disease (I69) in Korea between January 2016 and December 2018. We compared the demographic characteristics, diagnosis code subtypes, frequency of healthcare utilization, medical costs, and comorbidities of standard care (SC) and Korean medicine (KM) users. Overall, patients aged ≥ 65 years accounted for the highest percentage, and utilization of medical services increased among patients aged ≥ 45 years. Outpatient care was higher among SC (79.23%) and KM (99.38%) users. Sequelae of cerebral infarction accounted for the highest percentage of diagnosis subtypes. Physical therapy and rehabilitation therapy were most frequent in SC, whereas injection/procedure and acupuncture were most frequent in KM. Cerebrovascular circulation/dementia drugs were prescribed most frequently in SC. Circulatory, digestive, endocrine, and metabolic disorders were the most common comorbidities in SC, whereas musculoskeletal and connective tissue disorders were most common in KM. Overall, SC and KM users showed differences in the number of medical service claims, cost of care, and comorbidities. Our findings provide basic research data for clinicians, researchers, and policy makers.

Figure 1

Flowchart of the study design. HIRA-NPS: Health Insurance Review and Assessment Service-National Patients Sample; SC: Standard care; KM: Korean medicine.

Figure 2

Patients diagnosed with subtypes of code I69. Hemorrhage: Sequelae of subarachnoid hemorrhage (I69.0), Sequelae of intracerebral hemorrhage (I69.1), Sequelae of other nontraumatic intracranial hemorrhage (I69.2); Infarction: Sequelae of cerebral infarction (I69.3); Others: Sequelae of stroke, not specified as hemorrhage or infarction (I69.4); Unspecified: Sequelae of other and unspecified cerebrovascular diseases (I69.8).