Comparison of Trends in the Incidence of Traumatic Spinal Cord Injury in Daily Life, Automobile Accidents, and Industrial Accidents: A National Multi-Insurance Study in Korea

J Korean Med Sci, 2023 · DOI: 10.3346/jkms.2023.38.e26 · Published: February 20, 2023

Simple Explanation

This study examines the trends in traumatic spinal cord injury (TSCI) incidence in South Korea using three insurance databases: the National Health Insurance Service (NHIS), automobile insurance (AUI), and Industrial Accident Compensation Insurance (IACI). The data reveals differing trends based on the insurance type, indicating the need for tailored medical strategies. The NHIS data, covering the entire Korean population, shows an increase in TSCI incidence, particularly among those in their 70s or older. The AUI data shows a decrease, while the IACI data shows a less significant trend. These variations likely reflect different injury etiologies and insured populations. The study highlights that the proportion of cervical spinal cord injuries is the most common across all three databases, suggesting a consistent pattern of injury type regardless of the insurance system.

Study Duration

NHIS: 2009-2018, AUI and IACI: 2014-2018

Participants

South Korean population covered by NHIS, AUI, and IACI

Evidence Level

Not specified

Key Findings

1
The age-adjusted incidence of TSCI increased significantly in the NHIS database from 2009 to 2018, while it decreased significantly in the AUI database from 2014 to 2018.
2
Older patients (60s and 70s or older) showed a high incidence of TSCI across all three insurance databases, with a dramatic increase in the NHIS and IACI databases.
3
The proportion of patients with cervical spinal cord injury was the most common in all three databases.

Research Summary

This study investigates the incidence trends of traumatic spinal cord injury (TSCI) in South Korea using three distinct national insurance databases: NHIS, AUI, and IACI. The analysis reveals varying trends across the databases, indicating differences in injury etiologies and insured populations. Key findings include a significant increase in TSCI incidence in the NHIS database, a decrease in the AUI database, and a high incidence among older adults across all databases. Cervical spinal cord injuries are the most prevalent type in all three databases. The study concludes that tailored medical strategies are needed for different injury types represented by the three national insurance systems, considering the diverse characteristics and etiologies associated with each insurance scheme.

Practical Implications

Tailored Medical Strategies

Develop specific medical and rehabilitation programs based on the insurance type (NHIS, AUI, IACI) to address the unique characteristics and needs of each patient group.

Prevention Strategies

Implement targeted prevention strategies, such as traffic safety campaigns for AUI-covered individuals and workplace safety measures for IACI-covered individuals, to reduce the incidence of TSCI.

Healthcare Resource Allocation

Allocate healthcare resources and infrastructure to meet the increasing needs of older adults with TSCI, particularly within the NHIS and IACI systems, focusing on early rehabilitation and long-term care.

Study Limitations

1
The overall incidence of TSCI in South Korea could not be accurately determined due to the inability to merge the three insurance databases.
2
Potential misclassification errors in ICD-10 coding may have affected the accuracy of incidence rates.
3
The AUI and IACI data had a shorter follow-up period (five years) compared to the NHIS data (ten years), limiting the ability to analyze long-term trends.

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