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JKM > Volume 44(1); 2023 > Article
Lim, Ahn, Yu, Kim, and Park: Study on the distribution in major disease category and frequency of clinical usage of national health insurance herbal prescription based on analysis on KCD8 disease code of indications

Abstract

Objectives
National health insurance herbal prescription of Korean medicine has been serving important role in public healthcare in spite of continuous demand on revision of system. However, the categories of insurance herbal prescriptions are not equally distributed throughout the KCD-based major disease categories. We analyzed statistical database of claimed national health insurance classified as major disease categories by years. We classified all 56 herbal prescriptions as per their total medical indications into 22 major disease categories to analyze their distribution. Significant increase of M and S-T code claims were found, whereas decrease of U code claims by years. We figured out that the 56 prescriptions were unequally distributed along with enrichment of certain codes such as K and J. Meanwhile, the insurance claim of each prescription was positively correlated with number of code types of their indications. As a result, we believe that the reform of national health insurance herbal prescription list is necessary to promote use of it in clinic.

Fig. 1
The trends of number of patients in all types of Korean medicine clinic classified as 22 major disease categories by years (2010–2020).
jkm-44-1-1f1.gif
Fig. 2
The simple linear regression analysis showing the trends of number of patients by major disease codes that shown significant changes in ratio by years (2010–2020). (a) Codes that the ratio of patients has been increased (b) Codes that the ratio of patients has been decreased.
jkm-44-1-1f2.gif
Fig. 3
Distribution analysis over 22 major disease categories of all indications from 56 national health insurance herbal prescriptions. (a) Includes counts of duplicate indications. (b) Excludes counts of duplicate indications.
jkm-44-1-1f3.gif
Fig. 4
Distribution ratio analysis over consisting indications of 22 major disease categories from each of 56 national health insurance herbal prescriptions.
jkm-44-1-1f4.gif
Fig. 5
Distribution of major disease code given to national health insurance herbal prescriptions based on their disease codes of all indications.
jkm-44-1-1f5.gif
Fig. 6
Web chart analysis of major disease code of all indications from frequently used or infrequently used herbal prescriptions (ranks from 1 to 5).
jkm-44-1-1f6.gif
Fig. 7
The simple linear regression analysis showing the correlation between the sorts of major disease code of all indications from herbal prescription and number of insurance claims of each herbal prescription.
jkm-44-1-1f7.gif
Fig. 8
Bubble plot presenting the sorts of major disease code of all indications, number of insurance claims, and fisher’s exact test result of indications from 56 herbal prescriptions.
jkm-44-1-1f8.gif
Table 1
The Number of Patients in All Types of Korean Medicine Clinic Classified as 22 Major Disease Categories by Years (2010–2020)
22 major disease codes 2010 2020
Certain infectious and parasitic diseases (A00-B99) 31,233 20,921
Neoplasms (C00-D48) 18,520 49,855
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89) 3,911 2,274
Endocrine, nutritional and metabolic diseases (E00-E90) 70,506 29,535
Mental and behavioural disorders (F00-F99) 210,234 83,753
Diseases of the nervous system (G00-G99) 687,681 513,990
Diseases of the eye and adnexa (H00-H59) 54,175 32,626
Diseases of the ear and mastoid process (H60-H95) 87,638 83,452
Diseases of the circulatory system (I00-I99) 103,665 63,353
Diseases of the respiratory system (J00-J99) 824,196 397,295
Diseases of the digestive system (K00-K93) 745,511 863,095
Diseases of the skin and subcutaneous tissue (L00-L99) 43,172 149,105
Diseases of the musculoskeletal system and connective tissue (M00-M99) 7,331,207 7,091,029
Diseases of the genitourinary system (N00-N99) 122,029 91,422
Pregnancy, childbirth and the puerperium (O00-O99) 11,844 4,843
Certain conditions originating in the perinatal period (P00-P96) 989 277
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q96) 3,427 1,237
Symptoms, signs and abnormal clinical and laboratory findings, NEC (R00-R99) 958,066 679,689
Injury, poisoning and certain other consequences of external causes (S00-T98) 4,261,689 4,414,304
Factors influencing health status and contact with health services (Z00-Z99) 5,138 3,772
Codes for special purposes (U00-U99) 1,598,163 677,983
ETC 431,340 77,598
Table 2
The Analysis of Proportion Changes in Number of Patients in All Types of Korean Medicine Clinic Classified as 22 Major Disease Categories During 2010–2020.
Changes Codes Slope P value
Claims Insignificantly changed R −0.03759 0.2652
A,B −0.0007779 0.6382
Z −0.0006077 0.2815
D −2.50E-05 0.925

Claims Significantly Decreased U −0.5376 0.0001
ETC −0.2662 0.0006
J −0.1547 0.0003
F −0.0607 0.0001
G −0.03795 0.0009
E −0.01391 0.0028
I −0.01342 0.0002
N −0.009918 0.0003
H1 −0.004823 0.0444
O −0.002953 0.0001
Q −0.001009 0.0001
P −0.0003383 0.0005

Claims Significantly increased H2 0.007148 0.0002
C,D 0.02256 0.0001
L 0.1081 0.0017
K 0.1797 0.0022
M 0.4085 0.0001
S,T 0.4165 0.0001
Table 3
Analysis of the Distribution Ratio of Major Disease Code Given to National Health Insurance Herbal Prescriptions Based on Their Disease Codes of All Indications
Kcd 코드 A+B C+D E F G H I J K L M N O R S T Disease code
보험제제
1. 가미소요산 0.1875 0.1250 0.1875 0.5000 R

2. 갈근탕 0.2000 0.1000 0.6000 0.1000 J

3. 갈근해기탕 0.6250 0.3750 J

4. 구미강활탕 0.0833 0.0833 0.1667 0.5833 0.0833 M

5. 궁소산 1.0000 O

6. 궁하탕 0.2500 0.2500 0.1250 0.3750 R

7. 내소산 0.1667 0.8333 K

8. 당귀연교음 1.0000 K

9. 당귀육황탕 0.3333 0.3333 0.3333 R

10. 대시호탕 0.0417 0.0417 0.2500 0.0833 0.1667 0.2083 0.2083 F

11. 대청룡탕 0.0909 0.8182 0.0909 J

12. 대화중음 0.2500 0.5833 0.1667 K

13. 대황목단피탕 0.8000 0.2000 K

14. 도인승기탕 0.1667 0.1111 0.2778 0.2778 0.1667 I

15. 반하백출천마탕 0.3846 0.0769 0.0769 0.2308 0.2308 G

16. 반하사심탕 0.2500 0.5000 0.2500 K

17. 반하후박탕 0.2000 0.4000 0.4000 K

18. 백출탕 1.0000 J

19. 보중익기탕 0.0588 0.0294 0.0882 0.0882 0.0588 0.2059 0.0294 0.1765 0.1765 0.0294 0.0588 K

20. 보허탕 0.2500 0.7500 O

21. 복령보심탕 0.5000 0.2500 0.2500 I

22. 불환금정기산 0.6667 0.2500 0.0833 J

23. 삼소음 0.8571 0.1429 J

24. 삼출건비탕 0.1250 0.8750 K

25. 삼호작약탕 1.0000 N

26. 삼황사심탕 0.1111 0.4444 0.2222 0.2222 I

27. 생맥산 0.7500 0.2500 J

28. 소시호탕 0.0833 0.2083 0.3333 0.1250 0.0833 0.1250 0.0417 J

29. 소청룡탕 0.0667 0.6000 0.2000 0.1333 J

30. 승양보위탕 1.0000 K

31. 시경반하탕 0.1667 0.6667 0.1667 J

32. 시호계지탕 0.1667 0.1667 0.1667 0.3333 0.1667 K

33. 시호소간탕 0.3333 0.1667 0.1667 0.3333 F

34. 시호청간탕 0.1429 0.7143 0.1429 L

35. 안태음 0.1667 0.8333 O

36. 연교패독산 0.6000 0.2000 0.2000 J

37. 오림산 0.7778 0.2222 N

38. 오적산 0.0400 0.1200 0.0400 0.0400 0.0400 0.3600 0.1600 0.2000 M

39. 이중탕 0.0833 0.7500 0.0833 0.0833 K

40. 이진탕 0.1000 0.3000 0.1000 0.2000 0.2000 0.1000 K

41. 익위승양탕 0.4000 0.4000 0.2000 E

42. 인삼패독산 0.1000 0.1000 0.7000 0.1000 J

43. 인진호탕 0.5000 0.5000 K

44. 자음강화탕 0.1429 0.4286 0.4286 R

45. 조위승기탕 0.2500 0.2500 0.2500 0.2500 K

46. 청상견통탕 0.3750 0.6250 I

47. 청서익기탕 0.5000 0.5000 R

48. 청위산 1.0000 K

49. 팔물탕 0.5000 0.5000 E

50. 평위산 0.1000 0.8000 0.1000 K

51. 행소탕 (산) 1.0000 J

52. 향사평위산 0.1667 0.1667 0.1667 0.5000 K

53. 황금작약탕 0.5000 0.5000 K

54. 황련해독탕 0.4444 0.1111 0.2222 0.1111 0.1111 F

55. 형개연교탕 0.5000 0.5000 J

56. 회춘양격산 1.0000 K

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