J Korean Med Sci.  2010 Sep;25(9):1259-1271. 10.3346/jkms.2010.25.9.1259.

Continuity of Care for Elderly Patients with Diabetes Mellitus, Hypertension, Asthma, and Chronic Obstructive Pulmonary Disease in Korea

• Hong JS
• Kang HC
• Kim J

• KMID: 1785903
• DOI: http://doi.org/10.3346/jkms.2010.25.9.1259

Abstract

We sought to assess continuity of care for elderly patients in Korea and to examine any association between continuity of care and health outcomes (hospitalization, emergency department visits, health care costs). This was a retrospective cohort study using the Korea National Health Insurance Claims Database. Elderly people, 65-84 yr of age, who were first diagnosed with diabetes mellitus (n=268,220), hypertension (n=858,927), asthma (n=129,550), or chronic obstructive pulmonary disease (COPD, n=131,512) in 2002 were followed up for four years, until 2006. The mean of the Continuity of Care Index was 0.735 for hypertension, 0.709 for diabetes mellitus, 0.700 for COPD, and 0.663 for asthma. As continuity of care increased, in all four diseases, the risks of hospitalization and emergency department visits decreased, as did health care costs. In the Korean health care system, elderly patients with greater continuity of care with health care providers had lower risks of hospital and emergency department use and lower health care costs. In conclusion, policy makers need to develop and try actively the program to improve the continuity of care in elderly patients with chronic diseases.

Keyword

Continuity of Patient Care; Hospitalization; Health Care Costs; Diabetes Mellitus; Hypertension; Asthma; Pulmonary Disease, Chronic Obstructive

MeSH Terms

Aged
Aged, 80 and over
Asthma/*economics
Cohort Studies
Continuity of Patient Care/*economics
Costs and Cost Analysis
Databases, Factual
Diabetes Mellitus/*economics
Emergency Service, Hospital/economics
Female
Hospitalization/economics
Humans
Hypertension/*economics
Male
National Health Programs
Pulmonary Disease, Chronic Obstructive/*economics
Republic of Korea
Retrospective Studies
Risk

Figure

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  Fig. 1 Flowchart of the selected study subjects. COPD, chronic obstructive pulmonary disease; ED, emergency department visits.

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  Fig. 2 Continuity of care scores and the number of patients by the number of ambulatory care visits during the first 3 yr of the 4-yr follow up. COC, continuity of care; COPD, chronic obstructive pulmonary disease.

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