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ICD Code: 493. Asthma



ICD Code: 493. Article Review
Title: Cho S-H et al; "The Current Status of Asthma in Korea." Journal of Korean Medical Science; V.21; 2006; p181
      PREVALENCE (KOREA): Recently, several large-scale studies of different populations in Korea have reported asthma prevalence ranging from 2% to 13%. These differences are probably ascribable to different case definitions, methodologies, and a tendency to survey children rather than adults due to the relative ease of implementing studies in a school environment. According to the latest summary issued by the global burden of asthma by the Global Initiative for Asthma (GINA) program, the prevalence of clinical asthma in Korea is estimated to be 3.9%. The prevalence of asthma tended to be higher in children than in adults and was found to depend significantly on their place of residence, for example, it was found to be higher in Seoul than in provincial cities.
      According to 1998 data, childhood asthma was less prevalent in Korea than in other developed countries. However, among the elderly (aged 65 years or older), its prevalence was found to be high at 12.7% in 2001, which is about 3 times higher than among English or U.S. elderly. Although estimates of asthma prevalence in older age groups differ greatly between countries because of overlapping diagnoses and poor patient perception of symptoms, this rate is unexpectedly high.
      UNDERDIAGNOSIS: In the elderly, asthma is an important problem because it is usually underdiagnosed and hence inadequately treated. Interestingly, Korean adults and children appear to have a later average age of asthma onset than other Asian populations. This is likely to be due to the underdiagnosis of early stage asthma by general physicians. Some investigators have reported that an underdiagnosis rate by general physicians was 21%. Another contributing factor may be that a high proportion of Korean people, at least initially, turn to traditional medicine for medical help, which delays the diagnosis until they are referred to hospitals or emergency department with severe symptoms. Finally, racial differences may be a consideration.
      RISK FACTORS: Age, sex, affluence, genetic predisposition, climate, outdoor air quality and cigarette smoking have all been found to be associated with asthma. Studies suggest a higher incidence of asthma in children than in adults, and male asthmatic patients were found to be more often hospitalized or treated at a tertiary medical centers than their female counterparts. In a regression analysis of the Asthma Insights and Reality in Asia-Pacific (AIRIAP) data for the eight areas of Asia-Pacific countries including Korea, it was found that a low household income is significantly associated with the likelihood of having moderate or severe persistent asthma symptoms.
      MORTALITY: The accurate determination of asthma mortality in Korea is difficult because large-scale medical databases tend to group asthma data along with those of other disease states or with less specific group diagnoses such as "chronic lower respiratory diseases."
      COST: At present, little data is available on the economic burden posed by asthma in Korea. However, indirect estimates may be made based on the market shares of asthma medications in Korea. According to the data from the pharmaceutical industry, from 2001 to 2004 the annual gross value of drugs sold in Korea increased by nearly 50% (from US$3.48 to US$5.21 billion) and the proportion shared by drugs for asthma treatment in respiratory drug market increased by approximately 36% (from US$51.8 to US$70.6 million). Research in this area is underway, with a large-scale analysis being performed using data from Health Insurance Review Agency (HIRA), the 1998 National Survey on Health and Nutrition in Korea, and an ongoing patient survey.
     
     

Search Criteria: Text - Journal of Korean Medical Science; V.21; 2006; p181