Health Policy Manag.  2019 Sep;29(3):262-276. 10.4332/KJHPA.2019.29.3.262.

Effects of Outpatient Continuity of Primary Care on Hospitalization in Patients with Diabetes Mellitus: Focused on New Patients in 2012

• Shin YJ
• Woo KS
• Shin YJ

• KMID: 2460875
• DOI: http://doi.org/10.4332/KJHPA.2019.29.3.262

Abstract

BACKGROUND
The most important thing to strengthen primary care is to prove that the continuity of primary care is an essential area for good health outcomes. The purpose of this study is to analyze the effect of outpatient continuity of primary care on the hospitalization experience of diabetes mellitus in new diabetic patients.
METHODS
Using the Korean National Health Insurance Service national sample cohort (NHIS-NSC 2011-2015) data, 3,391 new diabetic patients in 2012 were selected for the study. Multiple logistic regression was performed to investigate the effect of outpatient continuity of primary care on hospitalization in new diabetic patients.
RESULTS
The outpatient continuity of primary care in new diabetic patients was measured by the continuity of care index, which showed that 69.4% (n=2,352) were high level and 30.6% (n=1,039) were low level. Patients who had high continuity of primary care at the early stage of diabetes diagnosis showed 3.49 times more likely to maintain high continuity of primary care in the second year (95% confidence interval [CI], 2.72-4.49). Patients with low continuity of primary care for 2 years from the initial diagnosis of diabetes were 2.56 times more likely to be hospitalized due to diabetes than those who did not (95% CI, 1.55-4.25).
CONCLUSION
This study identified the need for policies to increase the continuity of primary care for new diabetic patients and could contribute to lowering the admission rate of diabetic patients if the policy for this would work effectively.

Keyword

Primary health care; Continuity of patient care; Diabetes mellitus

MeSH Terms

Cohort Studies
Continuity of Patient Care
Diabetes Mellitus*
Diagnosis
Hospitalization*
Humans
Logistic Models
National Health Programs
Outpatients*
Primary Health Care*