J Korean Med Assoc.  2013 Jan;56(1):62-71. 10.5124/jkma.2013.56.1.62.

Economic burden of otitis media and a survey of physicians for its practice and claim codes in Korea

• Chun BC
• Sohn WY
• Jung W
• Lee HJ

• KMID: 2192902
• DOI: http://doi.org/10.5124/jkma.2013.56.1.62

Abstract

Otitis media (OM) is one of the most common pediatric infectious diseases. The burden of OM is known in many countries, but data for Korea has not been collected. The primary objective of this study was to evaluate the disease burden of OM in both children and adults. The Health Insurance Review and Assessment database study was analyzed to estimate the clinical and economic burden of OM and acute OM (AOM) for 2004. OM was defined as all cases coded H65, H66, or H67 and AOM cases coded H65, H65.0, H65.1, H65.9, H66, H66.4 or H66.9. For AOM, repeated visits within 30 days were considered to be one episode. Age specific incidence, and direct and indirect costs were estimated. A survey on pediatricians and otolaryngologists who most frequently diagnosed OM was carried out. The objective was to evaluate the accuracy of the claims made for OM and to examine the diagnosis and treatments of OM. A total of 5,964,587 claims for OM and 2,924,532 AOM episodes were reported. The incidence of outpatients presenting AOM was 60.9/1,000. The incidence of AOM was highest in children aged 1 year (736.9/1,000). The overall hospitalization rate due to AOM was 2.8/10,000, with a peak of 29.4/10,000 (1 year). The total cost incurred by AOM in Korea was estimated to be around 606.3 billion Korean won (KRW; 1,000 KRW is approximately US$1.00). The total cost of admissions was approximately 22.9 billion KRW, and the average cost of admission per person was about 1,690,000 KRW in a year. The cost of outpatient visits was 583.4 billion KRW, and 199,000 KRW per person. According to a survey of pediatricians and otolaryngologists on the accuracy of the OM diagnostic code, treatment, and prescription habits, the first-line diagnosis of AOM seemed to be fairly accurate. OM, including AOM, causes a considerable clinical and economic burden in Korea.

Keyword

Otitis media; Economic burden; Epidemiology

MeSH Terms

Adult
Aged
Child
Communicable Diseases
Hospitalization
Humans
Incidence
Insurance, Health
Korea
Otitis
Otitis Media
Outpatients
Prescriptions

Reference

1. Ahn HS. Hong CE, editor. Respiratory disorders. Pediatrics. 2005. 8th ed. Seoul: Daehan Textbook Publishing;653–681.

2. Freid VM, Makuc DM, Rooks RN. Ambulatory health care visits by children: principal diagnosis and place of visit. Vital Health Stat 13. 1998. (137):1–23.

3. Leibovitz E. Acute otitis media in pediatric medicine: current issues in epidemiology, diagnosis, and management. Paediatr Drugs. 2003. 5:Suppl 1. 1–12.

4. Pennie RA. Prospective study of antibiotic prescribing for children. Can Fam Physician. 1998. 44:1850–1856.

5. Rosenfeld RM, Kay D. Rosenfeld RM, Bluestone CD, editors. Natural history of untreated otitis media. Evidence-based otitis media. 2003. 2nd ed. Hamilton: BC Decker;180–198.

6. Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis. 1989. 160:83–94.

7. Rovers MM. The burden of otitis media. Vaccine. 2008. 26:Suppl 7. G2–G4.

8. Schwartz SR, Gates GA. Rosenfeld RM, Bluestone CD, editors. Economic costs. Evidence-based otitis media. 2003. 2nd ed. Hamilton: BC Decker;333–341.

9. Prymula R, Peeters P, Chrobok V, Kriz P, Novakova E, Kaliskova E, Kohl I, Lommel P, Poolman J, Prieels JP, Schuerman L. Pneumococcal capsular polysaccharides conjugated to protein D for prevention of acute otitis media caused by both Streptococcus pneumoniae and non-typable Haemophilus influenzae: a randomised double-blind efficacy study. Lancet. 2006. 367:740–748.

10. Park CS, Kang HY, Kwon I, Kang DR, Jung HY. Cost-of-illness study of asthma in Korea: estimated from the Korea National Health insurance claims database. J Prev Med Public Health. 2006. 39:397–403.

11. Jung YH, Ko S. The socioeconomic cost of diseases in Korea. J Prev Med Public Health. 2006. 39:499–504.

12. National Health Insurance Corporation. 2004 National health insurance statistical yearbook. 2005. Seoul: National Health Insurance Corporation.

13. National Health Insurance Corporation. A case study for insured patient's out-of-pocket medical service fees' 2004 [Internet]. 2005. cited 2013 Jan 4. Seoul: National Health Insurance Corporation;Available from: http://www.nhic.or.kr.

14. Korea Institute for Health and Social Affairs. 2004 National health and nutrition survey. 2005. Seoul: Korea Institute for Health and Social Affairs.

15. Hanna care. Fee for care [Internet]. cited 2013 Jan 4. Seoul: Hanna care;Available from: http://hcare.or.kr/htm/sub03_02.html.

16. Ministry of Labor. 2004 Survey report on wage structure. 2004. Gwacheon: Ministry of Labor.

17. Korean Statistical Information Service. 2004 Demographic data [Internet]. cited 2013 Jan 4. Dajeon: Statistics Korea;Available from: http://kosis.kr/abroad/abroad_01List.jsp?parentId=A.

18. Melegaro A, Edmunds WJ, Pebody R, Miller E, George R. The current burden of pneumococcal disease in England and Wales. J Infect. 2006. 52:37–48.

19. Eskola J, Kilpi T, Palmu A, Jokinen J, Haapakoski J, Herva E, Takala A, Kayhty H, Karma P, Kohberger R, Siber G, Makela PH. Finnish Otitis Media Study Group. Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med. 2001. 344:403–409.

20. Fireman B, Black SB, Shinefield HR, Lee J, Lewis E, Ray P. Impact of the pneumococcal conjugate vaccine on otitis media. Pediatr Infect Dis J. 2003. 22:10–16.

21. Chonmaitree T, Revai K, Grady JJ, Clos A, Patel JA, Nair S, Fan J, Henrickson KJ. Viral upper respiratory tract infection and otitis media complication in young children. Clin Infect Dis. 2008. 46:815–823.

22. Alsarraf R, Jung CJ, Perkins J, Crowley C, Alsarraf NW, Gates GA. Measuring the indirect and direct costs of acute otitis media. Arch Otolaryngol Head Neck Surg. 1999. 125:12–18.

23. Coyte PC, Asche CV, Elden LM. The economic cost of otitis media in Canada. Int J Pediatr Otorhinolaryngol. 1999. 49:27–36.