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Greater continuity of care reduces hospital admissions in patients with hypertension: An analysis of nationwide health insurance data in Korea, 2011-2013.

 Young Soon Nam  ;  Kyoung Hee Cho  ;  Hee-Chung Kang  ;  Kwang-Sig Lee  ;  Eun-Cheol Park 
 HEALTH POLICY, Vol.120(6) : 604-611, 2016 
Journal Title
Issue Date
Adult ; Aged ; Continuity of Patient Care* ; Female ; Humans ; Hypertension/diagnosis* ; Hypertension/drug therapy ; Hypertension/epidemiology ; Incidence ; Insurance Claim Review* ; Male ; Middle Aged ; National Health Programs ; Patient Admission/statistics & numerical data* ; Patient Readmission ; Republic of Korea/epidemiology
Continuity of care ; Hospital admission ; Hypertension ; Recurrent event survival analysis
OBJECTIVES: To measure the association between time-dependent COC and recurrent hospital admissions in patients with hypertension. DATA SOURCES: Korean National Health Insurance Claims Database (KNHI), between 2011 and 2013. METHODS: We used Korean National Health Insurance Claims Database (KNHI) during 2011-2013 to evaluate the association between continuity of care and hospital admission in adult patients with hypertension. We performed a recurrent event survival analysis analyzing the effect of COC on hospital admissions via Cox proportional hazard regression analysis. RESULTS: The adjusted risk of hospital admission for individuals with less COC (COC index <0.75) increased 42% (HR 1.42; 95% CI, 1.10-1.83) relative to the reference group (COC index≥0.75). Relative to individuals with a medication possession ratio (MPR) of ≥0.75, the adjusted hazard ratio for hospital admission was 2.09 (95% CI, 1.31-3.35) for those with an MPR of 0.00-0.24, 2.10 (95% CI, 1.30-3.39) for those with an MPR of 0.25-0.49, and 1.40 (95% CI, 0.82-2.39) for those with an MPR of 0.50-0.74. After 12 months, the cumulative incidence of hospital admissions was 0.42% for those with less COC and 0.25% for those with greater COC. CONCLUSIONS: Greater COC was associated with a decreased risk of hospital admission in patients with hypertension.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
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