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KMID : 1154920190140010012
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Korean Journal of Insurance Medicine
2019 Volume.14 No. 1 p.12 ~ p.25
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Min Seung-Ki
Cho In-Chang
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Abstract
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Introduction: Benign prostatic hyperplasia (BPH) is classically associated by the progressive development of lower urinary tract symptoms (LUTS). In many developing countries with an aging population, BPH associated with LUTS has become a major health issue. To optimize quality of care and control of cost, there is an imperative need to examine the pattern of BPH management. The goal of this study is to capture the Korean trend in surgical management of BPH during the last 5 years from 2014 to 2018.
Methods: We collected the medical statistical information of the Healthcare Big Data Opening System provided at the website of the Korea Health Insurance Review and Assessment Service. We analyzed the number of cases after 2014 by inputting R3975, R3976, R3977 codes for transurethral resection of prostate (TURP), photoselective vaporization of the prostate (PVP), and holmium laser enucleation of the prostate (HoLEP), respectively. Then, we analyzed and charted the number of cases according to hospitalized/outpatients, age groups, types of medical institutions, and the location of medical institutions.
Results: The number of patients with BPH has been steadily increasing, and the annual rate of increase has reached about 6.2%. In addition, the total amount of medical care costs is also increasing, which is about 12.3% per year higher than the increase in the number of patients. However, the increase in the total number of major 3 major operations for BPH was relatively mild at 5.2% for 5 years. The number of TURP and HoLEP steadily increased, while the number of PVP decreased dramatically. The cases of HoLEP has increased by 22% from 2014 to 2018, the fastest rate among the three surgeries. In addition, the number of patients aged 75 years or older is increasing, and the proportion of inpatient surgery is increasing rather than outpatient. The number of cases of TURP increased rapidly in general hospital and the number of HoLEP increased in general hospitals and tertiary referral hospitals. This trend is spreading from metropolitan to provincial.
Conclusions: The number of BPH surgeries in Korea has been steadily increasing over the past five years. The incidence of TURP and HoLEP is increasing, and the age of patient undergoing surgery is gradually increasing. The trend of increased cases of TURP in general hospitals and increased cases of HoLEP in general hospitals and tertiary referral hospitals is spreading from metropolitan to provincial. Future development of various lasers is expected to stimulate the increase of BPH surgeries using laser.
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KEYWORD
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benign prostatic hyperplasia, surgery, Korean, trend
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