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Impact of continuity of care on preventable hospitalization of patients with type 2 diabetes: a nationwide Korean cohort study, 2002-10

Authors
 Kyoung Hee Cho  ;  Chung Mo Nam  ;  Young Choi  ;  Jae-Woo Choi  ;  Seon-Heui Lee  ;  Eun-Cheol Park 
Citation
 INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, Vol.28(4) : 478-485, 2016 
Journal Title
 INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE 
ISSN
 1353-4505 
Issue Date
2016
MeSH
Adult ; Aged ; Cohort Studies ; Continuity of Patient Care* ; Diabetes Mellitus, Type 2/therapy* ; Female ; Hospitalization/trends* ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Republic of Korea ; Survival Analysis ; Young Adult
Keywords
continuity of care ; fragmented care ; preventable hospitalization ; recurrent event survival analysis
Abstract
OBJECTIVE: To determine whether patients with greater continuity of care (COC) have fewer preventable hospitalizations. DESIGN: We conducted a cohort study using a stratified random sample of Korean National Health Insurance enrollees from 2002 to 2010. The COC index was calculated for each year post-diagnosis based on ambulatory care visits. We performed a recurrent event survival analysis via Cox proportional hazard regression analysis of preventable hospitalizations. STUDY PARTICIPANTS: A total of 5163 patients newly diagnosed with type 2 diabetes mellitus in 2003-6 and receiving oral hypoglycemic medication. MAIN OUTCOME MEASURE: Preventable hospitalization. RESULTS: Of 5163 eligible participants, 6.4% (n = 328) experienced a preventable hospitalization during the study period. The adjusted hazard ratio (HR) was 8.69 (95% CI, 2.62-28.83) for subjects with a COC score of 0.00-0.19, 7.03 (95% CI, 4.50-10.96) for those with a score of 0.20-0.39, 3.01 (95% CI, 2.06-4.40) for those with a score of 0.40-059, 4.42 (95% CI, 3.04-6.42) for those with a score of 0.60-0.79 and 5.82 (95% CI, 3.87-8.75) for those with a score of 0.80-0.99. The difference in cumulative incidence of preventable hospitalizations in patients with COC scores of 0.00-0.19 relative to those with COC scores of 1.00 was the greatest, at 0.97% points. CONCLUSIONS: Greater COC was associated with fewer preventable hospitalizations in subjects with type 2 diabetes.
Full Text
https://academic.oup.com/intqhc/article-lookup/doi/10.1093/intqhc/mzw050
DOI
10.1093/intqhc/mzw050
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152052
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