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Hospital Charges and Continuity of Care for Outpatients with Hypertension in South Korea: A Nationwide Population-Based Cohort Study from 2002 to 2013

 Jae-Hyun Kim  ;  Eun-Cheol Park  ;  Tae Hyun Kim  ;  Yunhwan Lee 
 Korean Journal of Family Medicine, Vol.38(5) : 242-248, 2017 
Journal Title
Korean Journal of Family Medicine(가정의학회지)
Issue Date
Continuity of Patient Care ; Hospitals
BACKGROUND: Continuity of care (COC) has received attention over the past decade. COC has also become increasingly important for hospital managers and policy makers because of competitive health care market conditions. The purpose of this study was to assess the association between hospital charges and patients' continuity of care-assessed by three indices of continuity of care-among outpatients with hypertension in South Korea.

METHODS: This study used the National Health Insurance Service-Cohort Sample Database from 2002 to 2013. A total of 247,125 participants were analyzed at baseline (2002); continuity of care was defined using the continuity of care index, the Herfindahl-Hirschman index (a new continuity of care index), and the "most frequent provider continuity" index. Primary analyses were based on the generalized estimating equation regression model, which accounts for correlation among individuals within each hospital.

RESULTS: After adjustment for age, sex, residential region, patient clinical complexity level, diagnosed code, hospital type, organization type, number of beds, number of doctors, and year, there was a negative correlation between hospital charges and continuity of care index (β=-0.163, P<0.0001), the Herfindahl-Hirschman index (β=-0.105, P<0.0001), and the "most frequent provider continuity" index (β=-0.131, P<0.0001). Subgroup analyses based on hospital type produced similar trends.

CONCLUSION: For all indices studied, hospital charges declined gradually with increasing continuity of care. Our study suggests that long-term, trusting partnerships between patients and physicians reduce hospital costs.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
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