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KMID : 0607720140250030159
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Journal of Korean Community Nursing
2014 Volume.25 No. 3 p.159 ~ p.169
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Effectiveness of Community-based Case Management for Patients with Hypertension
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Yun Soon-Nyoung
Lee In-Sook
Kim Jin-Hyun
Ko Young
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Abstract
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Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization.
Methods: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA.
Results: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group.
Conclusion: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.
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KEYWORD
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Case management, Hypertension, Utilization, Health care, Health care costs
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