KMID : 0387320190290030277
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Korean Journal of Health Policy and Administration 2019 Volume.29 No. 3 p.277 ~ p.287
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Effects of Continuity of Care on Diabetes-Related Avoidable Hospitalizations among Middle- and Old-Aged Patients: Analysis of National Health Insurance Claims Data
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Kim Bo-Ah
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Abstract
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Background: Diabetes is known as one of the most important ambulatory care sensitive conditions. This study purposed to assess the status of continuity of care (COC) and diabetes-related avoidable hospitalizations (DRAHs) of a group of middle- and old-aged patients and to observe the relationship of the two elements by the two age groups.
Methods: This study utilized the National Health Insurance Service¡¯s National Sample Cohort data and the subjects are diabetes patients of 45 and over, classified into two groups of ¡®middle-aged¡¯(45?64 years) and ¡®old-aged¡¯(¡Ã65 years) patients. The dependent variable was DRAHs, which was defined in accordance with the definition of the Organization for Economic Cooperation and Development ¡°Health Care Quality Indicators¡± project. COC, as an independent variable, is measured by the COC index in this study. Two-part model (multi-variate and multi-level analyses) was utilized.
Results: Factors associated with the status and the number of DRAHs differed by each age group. Meanwhile, the two-part model showed that higher COC was associated with a lower risk of preventable hospitalizations in both middle- and old-aged groups.
Conclusion: Study findings can provide health policy insights and implications in order to strengthen the primary care system for further improvement of diabetes management, especially for middle- and old-aged groups.
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KEYWORD
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Diabetes-related avoidable hospitalizations, Continuity of care, Middle- and old-aged patients, Primary care, Older people
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