Abstract

Purpose
To evaluate the impacts of regional and socioeconomic factors on adolescent idiopathic scoliosis (AIS) diagnosis and treatment using national datasets of the Korean National Health Insurance System. The prevalence of, and therapeutic trends in, AIS are affected by a variety of environmental factors.
Materials and Methods
We analyzed random samples from datasets (10% of all entries) between 2012 and 2018, including in terms of patient demographics, residential status (a “special city”, and urban, and rural regions) and socioeconomic status (SES) based on health insurance premiums (which distinguish National Health Insurance and Medical Aid [MA] beneficiaries).
Results
The AIS prevalence was approximately 1.6-fold higher in females than in males, whereas the rate of male surgery was approximately 1.5-fold higher than that in females. AIS prevalence was higher among National Health Insurance beneficiaries (in all years), whereas the surgery rate was higher among MA beneficiaries (in most years). In all years, AIS prevalence was significantly higher among special city residents than in urban and rural residents. However, the surgical treatment rates were higher in the latter regions.
Conclusions
Our nationwide evaluation revealed AIS prevalence rates and therapeutic trends. AIS epidemiology varies by region and economic status.

• Keywords: Adolescent idiopathic scoliosis, Prevalence, Regional difference, Nationwide, Socioeconomic status