Abstract

This study researched in 247 primary local governments around Korea for the target of 2,266,451 patients, who are diagnosed with asthma (J45-J46) as the principal diagnosis in the year of 2010 by using their health insurance claim data. As the result of analyzing influence factors of prevalence rate and medical expenses for the asthma disease caused by ecological conditions in each area, this study tried to propose desirable environmental protection policy for each local area to prevent cause of asthma.
After analyzing data of health insurance claims, prevalence rate of asthma for overall people of 1 year old or older is 45.5 per population of 1,000 people, while infants were counted as 248.5 and elderly resulted as 61.2. However, for areas, which are included in top 25% of prevalence rate and medical expense, mostly were urban area, basin, industrial area, area with dam and coastal areas.
In order to find important influence factor related to asthma, hierarchical regression analysis was done and the result showed a meaningful difference in prevalence rate of asthma and medical expenses of overall population, infants and elderly people in accordance with size of the city in each area. In addition, when environment, Meteorology, terrain and geographic factors were added to socio-demographic and public health factors, all of model R-square of each factor has increased dramatically.
For overall population of people who are 1 year old or older, influence factors of prevalence rate and medical expense of asthma are found to be SO2, temperature difference, ratio of people in atmosphere discharge industry, mountain range area, basin, area with dam and coastal area. For infants, influence factors are SO2, temperature difference, mountain range area, basin, and area with dam. Lastly, main factors for elderly are NO2, ratio of people in atmosphere discharge industry, temperature difference and coastal area.
As above influence factors were considered for each area, even if concentration of air contaminant is below environmental standard, more infants were diagnosed with asthma in farming and fishing areas that has more natural allergen and lower-income group. On the other hand, elderly patients with asthma were more popular in urban areas that has higher air contaminant, therefore, they have to consider quality of life and social and economic burdens made by asthma.
In conclusion, prevalence rate and medical expenses for asthma is mutually and complicatedly affected by all of ecological factors such as air contaminant, sensitivity, living environment, climate, topography, and geographical factors. Therefore, environmental protection policy and prevent management business should be continued to customize for local area and also consider infants and elderly people, who are vulnerable to the disease, together with environments, topography and geographical factors in national level.