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A study on the effect of regional health insurance upon the appendectomy rate
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Yo Hwan Yang, Il Soon Kim, Hee Choul Oh
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Korean J Epidemiol. 1988;10(1):109-123.
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 Abstract
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Abstract
The objective of this study is to identify the change of the incidence and patterns of appendectomy due to the introduction of regional health insurance.
In order to compare the appendectomy rate before and after the introduction of regional health insurance, survey was performed in Kangwha county were the regional health insurance has implemented for all residents since July 1, 1982.
Seventy risidents from 3 townships (Seonwon, Buleun and Naega Myun) had received appendectomy from July 1, 1977 to June 30, 1982 and 790 people among all residents in the county had received appendectomy for the next 5 years(1982. 7.1-1987. 6.30).
The results are as follows:
1. The appendectomy rate before insurance was 8.7/10,000, but it was increased significantly to 22.4/10,000 after the insurance.
2. The appendectomy rate among young age group was increased remarkably, especially, the rate was increased by 12.4 times for female teen age group.
3. While the percentage of perforated appendicitis among appendectomy cases was decreased after the insurance, the rate of perforated appendicitis per 10,000 population was increased to only 1.9 times.
4. The appendectomy rate was increased more in the high economic group than that in low economic group.
5. During the 5 years after insurance, while the appendectomy rate had been increased steadily, complicated appendicitis rate had not been increased annually. Perforated appendicitis rate was slightly increased, but it was not statistically significant.
6. Higher levels of appendectomy rates in all clinical types were noted in high economic group compared with the low economic group.
7. Appendectomy rates and perforated appendicitis rate among the residents in islands (the lowest accessibility group) were higher than those of Myun and Eup. But it was not statistically significant.
From this result it was found that there are remarkable increase in appendectomy rate and appendicitis rate in Korean rural area after the implementation of regional health insurance. The reason for such increase may be due to the spontaneous remissions of appendicitis before insurance without surgery. To understand this phenomenon, there is a need to study the natural history of appendicitis in population for the further study.
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