J Korean Acad Fam Med.  1997 Aug;18(8):824-843.

The Study of Disease Structure and Utilization of Health Care Facility in the Elderly

• Cho KH
• Hong MH

Abstract

BACKGROUND: Rapid progress in medical science and technology has lengthened the average span of life in general population and accelerated the increase in the elderly. This gave rise to the expansion of chronic degenerative disease in the elderly, and then led to an increase in the utilization rate of health care facility and medical fee in sequence.
METHODS
In order to grope for an effective control program of chronic degenerative disease and to find out the characteristics of disease structure and utilization patterns of health care facility in the elderly, the author analysed the 6,072,196 cases of insured medical record of Federation of Korean Medical Insurance Societies from January 1st to December 31st of the year 1991.
RESULTS
Essential hypertension(5.94%) is the most common disease in the elderly. And what follows are gastritis and duodenitis(4.29%), acute bronchitis and bronchiolitis(3.68%), acute upper respiratory infection of multiple or unspecified site(3.47%) and diabetes mellitus(3.21%). Twenty most frequent diseases constitute the top 50.27% and one hundred constitute over 85% of all frequency of health care facility utilization. There are different patterns of diseases between two sexes. Pulmonary tuberculosis, chronic liver disease and cirrhosis, malignant neoplasm of stomach, chronic obstructive pulmonary disease, occlusion of cerebral arteries, sprains and strains of knee and leg, malignant neoplasm of trachea, bronchus and lung, other open wound of head, erythematosquamous dermatosis are more than 1.5 times higher in male by the standardized frequency ratio. There is a significant dissimilarity of disease structure between primary and other types of health care facility, which presents the point of reinforcement in primary care. The author has also noted elderly patients prefer secondary or tertiary health care facility in case of essential hypertension, diabetes mellitus, pulmonary tuberculosis, heart failure, duodenal ulcer, chronic liver disease and cirrhosis, funtional gastrointestinal disorder, hypertensive heart disease and chronic obstructive pulmonary disease which seems to be not so critical in most cases.
CONCLUSIONS
Patients of chronic degenerative disease tend to pursue the high quality of medical care and irregularly utilize health care delivery system.

MeSH Terms

Aged*
Bronchi
Bronchitis
Cerebral Arteries
Delivery of Health Care*
Diabetes Mellitus
Duodenal Ulcer
Fees, Medical
Fibrosis
Gastritis
Head
Heart Diseases
Heart Failure
Humans
Hypertension
Insurance
Knee
Leg
Liver Diseases
Lung
Male
Medical Records
Primary Health Care
Pulmonary Disease, Chronic Obstructive
Skin Diseases
Sprains and Strains
Stomach
Trachea
Tuberculosis, Pulmonary
Wounds and Injuries