Epidemiology and medical service use for spontaneous pneumothorax: a 12-year study using nationwide cohort data in Korea

Abstract

Objective: This study aimed to promote an understanding of spontaneous pneumothorax by analysing the prevalence rate and medical service use by patients with spontaneous pneumothorax according to sociodemographic characteristics.

Design: A 12-year nationwide study.

Setting: Data obtained from the Korean National Health Insurance Service Sharing Service.

Participants: A total of 4658 participants who used medical services due to spontaneous pneumothorax between 2002 and 2013 in Korea.

Outcome measures: For those diagnosed with spontaneous pneumothorax, use of medical services, hospitalisation data, sociodemographics, comorbidity, treatment administered and medication prescribed were recorded.

Results: The annual prevalence of spontaneous pneumothorax ranged from 39 to 66 per 100 000 individuals, while the prevalence of hospitalisation due to spontaneous pneumothorax ranged from 18 to 36 per 100 000 individuals. The prevalence rate of spontaneous pneumothorax in Korea has increased since 2002. The male to female ratio was approximately 4-10:1, with a higher prevalence rate in men. By age, the 15-34 years old group, and particularly those aged 15-19 years old, showed the highest prevalence rate; the rate then declined before increasing again for those aged 65 years or older. In total, 47%-57% of patients with spontaneous pneumothorax underwent hospitalisation. The average number of rehospitalisations due to pneumothorax was 1.56 per person, and more than 70% of recurrences occurred within 1 year. Chronic obstructive pulmonary disease was the most common comorbidity. The average treatment period was 11 days as an outpatient and 14 days in-hospital. The average medical costs were $94.50 for outpatients and $2523 for hospital admissions. The most common treatment for spontaneous pneumothorax was oxygen inhalation and thoracostomy, and the most commonly prescribed medications were analgesics, antitussives and antibiotics.

Conclusions: We here detailed the epidemiology and treatments for spontaneous pneumothorax in Korea. This information can contribute to the understanding of spontaneous pneumothorax.

Keywords: National Health Insurance Service-Sample Cohort Database (NHIS-SCD); epidemiology; longitudinal cohort; prevalence; primary spontaneous pneumothorax.