Background: The incidence of pneumonia in Korea started to increase in the 1990â??s after a period of decrease and\nstabilization, and the mortality and hospitalization rates for pneumonia in Korea are alarmingly high. This study was\nperformed to examine geographic variation and factors associated with hospitalization for bacterial pneumonia in\nKorea.\nMethods: Data were acquired from the inpatient claims of the 2015 period of the National Health Insurance\nService. The age- and sex-standardized hospitalization rates for bacterial pneumonia were calculated for three age\ngroups. Geographic variation was measured with the coefficient of variation, the ratio of the 90th to the 10th\npercentile of the distribution of rates, and the systematic component of variation. Considering the results of\nMoranâ??s I statistic which suggested spatial autocorrelation, we estimated spatial regression models using spatial\nerror models.\nResults: The hospitalization rate for bacterial pneumonia was 79.1 per 10,000 population, and the rate was the\nhighest in the age group 0-14 at 325.3, and it was 161.5 among the elderly. The geographic variation statistics\nshowed high variation with the coefficient variation at 0.6. The deprivation score showed positive associations,\nand the number of primary care physicians had a negative association with the hospitalization rates across all age\ngroups but the age group 0-14. The number of beds in hospitals with less than 300 beds had a positive\nassociation with the hospitalization rates for bacterial pneumonia, and the impact was the strongest in the age\ngroup 0-14.\nConclusions: The present study shows that pneumonia can be a major public health issue even in a developed\ncountry. Socioeconomic conditions can still be a concern for pneumonia in developed countries, and the role of\nprimary care physicians in preventing hospitalization for bacterial pneumonia needs to be recognized. Most of all,\nthe strong impact of hospital beds on the hospitalization rates for pneumonia, especially for the children, should be\naddressed. High disease burden of pneumonia in Korea can partly be attributable to oversupply of hospital beds.\nThese factors should be taken into consideration in establishing policy measures for the rise in pneumonia.
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