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Impact of Market Competition on Continuity of Care and Hospital Admissions for Asthmatic Children: A Longitudinal Analysis of Nationwide Health Insurance Data 2009-2013.

DC FieldValueLanguage
dc.contributor.author남정모-
dc.contributor.author박은철-
dc.contributor.author이상규-
dc.date.accessioned2017-02-24T11:09:31Z-
dc.date.available2017-02-24T11:09:31Z-
dc.date.issued2016-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/146664-
dc.description.abstractBACKGROUND: Ambulatory care-sensitive conditions, including asthma, can be managed with timely and effective outpatient care, thereby reducing the need for hospitalization. OBJECTIVE: This study assessed the relationship between market competition, continuity of care (COC), and hospital admissions in asthmatic children according to their health care provider. METHODS: A longitudinal design was employed with a 5-year follow-up period, between 2009 and 2013, under a Korean universal health insurance program. A total of 253 geographical regions were included in the analysis, according to data from the Korean Statistical Office. Data from 9,997 patients, aged ≤ 12 years, were included. We measured the COC over a 5-year period using the Usual Provider Continuity (UPC) index. Random intercept models were calculated to assess the temporal and multilevel relationship between market competition, COC, and hospital admission rate. RESULTS: Of the 9,997 patients, 243 (2.4%) were admitted to the hospital in 2009. In the multilevel regression analysis, as the Herfindahl-Hirschman Index increased by 1,000 points (denoting decreased competitiveness), UPC scores also increased (ß = 0.001; p < 0.0001). In multilevel logistic regression analysis, the adjusted odds ratio (OR) for hospital admissions for individuals with lower COC scores (≥ 2 ambulatory visits and a UPC index score of < 1) was 3.61 (95% CI: 2.98-4.38) relative to the reference group (≥ 2 ambulatory visits and a UPC index score of 1). CONCLUSIONS: Market competition appears to reduce COC; decreased COC was associated with a higher OR for hospital admissions.-
dc.description.statementOfResponsibilityopen-
dc.format.extente0150926-
dc.languageEnglish-
dc.publisherPublic Library of Science-
dc.relation.isPartOfPLOS ONE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAmbulatory Care/statistics & numerical data-
dc.subject.MESHAsthma*-
dc.subject.MESHChild-
dc.subject.MESHChild, Preschool-
dc.subject.MESHContinuity of Patient Care/statistics & numerical data-
dc.subject.MESHFemale-
dc.subject.MESHHospitalization/statistics & numerical data*-
dc.subject.MESHHumans-
dc.subject.MESHInfant-
dc.subject.MESHInfant, Newborn-
dc.subject.MESHInsurance, Health/statistics & numerical data*-
dc.subject.MESHLongitudinal Studies-
dc.subject.MESHMale-
dc.titleImpact of Market Competition on Continuity of Care and Hospital Admissions for Asthmatic Children: A Longitudinal Analysis of Nationwide Health Insurance Data 2009-2013.-
dc.typeArticle-
dc.publisher.locationUnited States-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Preventive Medicine-
dc.contributor.googleauthorKyoung Hee Cho-
dc.contributor.googleauthorEun-Cheol Park-
dc.contributor.googleauthorYoung Soon Nam-
dc.contributor.googleauthorSeon-Heui Lee-
dc.contributor.googleauthorChung Mo Nam-
dc.contributor.googleauthorSang Gyu Lee-
dc.identifier.doi10.1371/journal.pone.0150926-
dc.contributor.localIdA01264-
dc.contributor.localIdA01618-
dc.contributor.localIdA02811-
dc.relation.journalcodeJ02540-
dc.identifier.eissn1932-6203-
dc.identifier.pmid26958850-
dc.contributor.alternativeNameNam, Jung Mo-
dc.contributor.alternativeNamePark, Eun Chul-
dc.contributor.alternativeNameLee, Sang Gyu-
dc.contributor.affiliatedAuthorNam, Jung Mo-
dc.contributor.affiliatedAuthorPark, Eun Chul-
dc.contributor.affiliatedAuthorLee, Sang Gyu-
dc.citation.volume11-
dc.citation.number3-
dc.citation.startPagee0150926-
dc.identifier.bibliographicCitationPLOS ONE, Vol.11(3) : e0150926, 2016-
dc.date.modified2017-02-24-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers

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