Population-based prevalence of bronchiectasis and associated comorbidities in South Korea

Abstract

Bronchiectasis is a chronic respiratory disease characterised by abnormal dilatation of bronchi, which presents clinically with cough, sputum production and recurrent infection [1]. Although bronchiectasis had been regarded as an "orphan" disease [2], recent studies have shown that the prevalence of bronchiectasis is increasing and this disease causes a significant burden on public health, including increased healthcare costs, hospital admission and mortality [3][4][5].Data on the prevalence of bronchiectasis and bronchiectasis-related comorbidities are relevant, since comorbidities are important factors for predicting the risk of mortality in patients with bronchiectasis [6]. However, epidemiological data on the prevalence of bronchiectasis remain limited, especially in Asian populations. Furthermore, only a few studies have included a comprehensive evaluation of the prevalence of bronchiectasis-related comorbidities among Asians [1,7]. Thus, in the present study, the overall prevalence of bronchiectasis and associated comorbidities were investigated using a representative sample of national health insurance claims data in South Korea.To identify patients with bronchiectasis and investigate their comorbidities, data were used from the 2012-2017 Health Insurance Review and Assessment Service, National Patient Sample (HIRA-NPS), which is nationally representative and open to the public for research purposes [8]. The HIRA-NPS data are cross-sectional and composed of health insurance claim records during the year. The database includes approximately 1 400 000 individuals each year drawn by 3% stratified random sampling by age and sex from the entire population who had claims records during the year. It also provides information on healthcare costs, composed of payer's amounts and patient's out-of-pocket costs. South Korea has a government-run mandatory national health security system; 97% of the population is enrolled in the National Health Insurance and 3% in Medical Aid programmes [9].

Bronchiectasis and increased mortality in patients with corticosteroid-dependent severe asthma: a nationwide population study

“… 8 , 22 , 23 Bronchiectasis was defined using the ICD-10 diagnosis code J47 (bronchiectasis). 24 Subjects with cystic fibrosis (ICD-10 diagnosis code E84) were excluded.…”

KMBARC registry: protocol for a multicentre observational cohort study on non-cystic fibrosis bronchiectasis in Korea

“…Because the KMBARC registry is based on the framework of the EMBARC protocol, collaborative studies involving the two may help unravel racial differences in the aetiologies and phenotypes of bronchiectasis as well as bronchiectasis comorbidities 4. There is reason to suspect racial and ethnic differences in many aspects of bronchiectasis since we have demonstrated lower prevalence of COPD and cardiovascular diseases in the Korean population than in the Western population 6 38. However, the reasons for these ethnic differences remain unclear due to insufficient information contained in the national health insurance database.…”

“…Despite the lack of epidemiological data in Korea, epidemiological studies have demonstrated that bronchiectasis poses a significant burden on public health, including increased healthcare costs, hospital admission and mortality 20–22. Therefore, we conducted a nationwide database study on the prevalence of bronchiectasis in Korea 6. Our study demonstrated that the prevalence of non-cystic fibrosis bronchiectasis was 464 cases per 100 000 population, which was strikingly higher than that reported in Germany (67 cases per 100 000 population) and the USA (138 cases per 100 000 population) 23 24.…”

“…While these cohort studies have unravelled several important aspects of bronchiectasis, such as epidemiology, factors leading to disease exacerbations, quality of life and mortality,5 they lack inclusivity. Specifically, only few Asian patients have been included, and considering the prevalence and disease burden of bronchiectasis in these patients, which are more substantial than those in the Western population,6 there is an urgent need to evaluate the clinical characteristics, aetiologies, comorbidities and prognosis of this disease among Asian populations, including the Korean population. We have established the Korean Multicentre Bronchiectasis Audit and Research Collaboration (KMBARC) to: (1) evaluate the clinical characteristics and phenotypes of bronchiectasis in Korea; (2) promote clinical studies on bronchiectasis in Korea; and (3) improve patient care and education among Korean patients with bronchiectasis.…”

Validation of the Korean Version of the Bronchiectasis Health Questionnaire

“…Bronchiectasis is increasing in prevalence and escalates the public health burden, resulting in increased health care costs, hospitalization rates, and mortality 2,3 . A recent study in Korea using a government health insurance database showed that the prevalence of bronchiectasis in Korea was higher than that in other Western countries, and the healthcare cost was high 4 . In addition to the high prevalence and economic burden, assessment of health-related quality of life (HRQOL) is important in chronic diseases such as bronchiectasis, as it can evaluate the overall impact on health from the patient' s point of view.…”