Effects of continuity of care on hospital admission in patients with type 2 diabetes

Analysis of nationwide insurance data Organization, structure and delivery of healthcare

Kyoung Hee Cho, Sang Gyu Lee, Byungyool Jun, Bo Young Jung, Jae Hyun Kim, Euncheol Park

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: A system for managing chronic disease including diabetes mellitus based on primary care clinics has been used in Korea since April 2012. This system can reduce copayments for patients that are managed by a single primary-care provider and lead to improve continuity of care. The aim of this study is to determine whether there is an association between continuity of care for outpatients and hospital admission and identify the continuity index that best explains hospital admissions for patients with type 2 diabetes. Methods: We performed a cross-sectional study using 2009 National Health Insurance Sample (NHIS) from the Health Insurance Review & Assessment Services (HIRA) of Korea. The dependent variable was hospital admission due to type 2 diabetes mellitus. Continuity of care was measured using the Usual Provider Care index (UPC), Continuity of Care index (COC), Sequential Continuity of Care index (SECON), and Integrated Continuity of Care index (ICOC). Results: Patients with low COC scores (<0.75) were more likely to be hospitalized [odds ratio, 2.44; 95% CI, 2.17-2.75] compared with the reference group (COC ≥0.75), after adjusting for all covariates. we calculated the area under the receiver operating characteristic (AUROC) curve for each index to find which index had the greatest explanatory ability for hospital admission. The AUROC of the COC was the greatest (0.598), but the AUROC curves for the UPC (0.597), SECON (0.593), and ICOC (0.597) were similar. Conclusions: High continuity of care may reduce the likelihood for hospital admission. The COC had marginally more explanatory power.

Original languageEnglish
Article number107
JournalBMC Health Services Research
Volume15
Issue number1
DOIs
Publication statusPublished - 2015 Mar 17

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Continuity of Patient Care
Patient Admission
Insurance
Type 2 Diabetes Mellitus
Delivery of Health Care
ROC Curve
Korea
Primary Health Care
National Health Programs
Health Insurance
Diabetes Mellitus
Chronic Disease
Outpatients

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

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title = "Effects of continuity of care on hospital admission in patients with type 2 diabetes: Analysis of nationwide insurance data Organization, structure and delivery of healthcare",
abstract = "Background: A system for managing chronic disease including diabetes mellitus based on primary care clinics has been used in Korea since April 2012. This system can reduce copayments for patients that are managed by a single primary-care provider and lead to improve continuity of care. The aim of this study is to determine whether there is an association between continuity of care for outpatients and hospital admission and identify the continuity index that best explains hospital admissions for patients with type 2 diabetes. Methods: We performed a cross-sectional study using 2009 National Health Insurance Sample (NHIS) from the Health Insurance Review & Assessment Services (HIRA) of Korea. The dependent variable was hospital admission due to type 2 diabetes mellitus. Continuity of care was measured using the Usual Provider Care index (UPC), Continuity of Care index (COC), Sequential Continuity of Care index (SECON), and Integrated Continuity of Care index (ICOC). Results: Patients with low COC scores (<0.75) were more likely to be hospitalized [odds ratio, 2.44; 95{\%} CI, 2.17-2.75] compared with the reference group (COC ≥0.75), after adjusting for all covariates. we calculated the area under the receiver operating characteristic (AUROC) curve for each index to find which index had the greatest explanatory ability for hospital admission. The AUROC of the COC was the greatest (0.598), but the AUROC curves for the UPC (0.597), SECON (0.593), and ICOC (0.597) were similar. Conclusions: High continuity of care may reduce the likelihood for hospital admission. The COC had marginally more explanatory power.",
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Effects of continuity of care on hospital admission in patients with type 2 diabetes : Analysis of nationwide insurance data Organization, structure and delivery of healthcare. / Cho, Kyoung Hee; Lee, Sang Gyu; Jun, Byungyool; Jung, Bo Young; Kim, Jae Hyun; Park, Euncheol.

In: BMC Health Services Research, Vol. 15, No. 1, 107, 17.03.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of continuity of care on hospital admission in patients with type 2 diabetes

T2 - Analysis of nationwide insurance data Organization, structure and delivery of healthcare

AU - Cho, Kyoung Hee

AU - Lee, Sang Gyu

AU - Jun, Byungyool

AU - Jung, Bo Young

AU - Kim, Jae Hyun

AU - Park, Euncheol

PY - 2015/3/17

Y1 - 2015/3/17

N2 - Background: A system for managing chronic disease including diabetes mellitus based on primary care clinics has been used in Korea since April 2012. This system can reduce copayments for patients that are managed by a single primary-care provider and lead to improve continuity of care. The aim of this study is to determine whether there is an association between continuity of care for outpatients and hospital admission and identify the continuity index that best explains hospital admissions for patients with type 2 diabetes. Methods: We performed a cross-sectional study using 2009 National Health Insurance Sample (NHIS) from the Health Insurance Review & Assessment Services (HIRA) of Korea. The dependent variable was hospital admission due to type 2 diabetes mellitus. Continuity of care was measured using the Usual Provider Care index (UPC), Continuity of Care index (COC), Sequential Continuity of Care index (SECON), and Integrated Continuity of Care index (ICOC). Results: Patients with low COC scores (<0.75) were more likely to be hospitalized [odds ratio, 2.44; 95% CI, 2.17-2.75] compared with the reference group (COC ≥0.75), after adjusting for all covariates. we calculated the area under the receiver operating characteristic (AUROC) curve for each index to find which index had the greatest explanatory ability for hospital admission. The AUROC of the COC was the greatest (0.598), but the AUROC curves for the UPC (0.597), SECON (0.593), and ICOC (0.597) were similar. Conclusions: High continuity of care may reduce the likelihood for hospital admission. The COC had marginally more explanatory power.

AB - Background: A system for managing chronic disease including diabetes mellitus based on primary care clinics has been used in Korea since April 2012. This system can reduce copayments for patients that are managed by a single primary-care provider and lead to improve continuity of care. The aim of this study is to determine whether there is an association between continuity of care for outpatients and hospital admission and identify the continuity index that best explains hospital admissions for patients with type 2 diabetes. Methods: We performed a cross-sectional study using 2009 National Health Insurance Sample (NHIS) from the Health Insurance Review & Assessment Services (HIRA) of Korea. The dependent variable was hospital admission due to type 2 diabetes mellitus. Continuity of care was measured using the Usual Provider Care index (UPC), Continuity of Care index (COC), Sequential Continuity of Care index (SECON), and Integrated Continuity of Care index (ICOC). Results: Patients with low COC scores (<0.75) were more likely to be hospitalized [odds ratio, 2.44; 95% CI, 2.17-2.75] compared with the reference group (COC ≥0.75), after adjusting for all covariates. we calculated the area under the receiver operating characteristic (AUROC) curve for each index to find which index had the greatest explanatory ability for hospital admission. The AUROC of the COC was the greatest (0.598), but the AUROC curves for the UPC (0.597), SECON (0.593), and ICOC (0.597) were similar. Conclusions: High continuity of care may reduce the likelihood for hospital admission. The COC had marginally more explanatory power.

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DO - 10.1186/s12913-015-0745-z

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