J Korean Diabetes.  2021 Jun;22(2):134-141. 10.4093/jkd.2021.22.2.134.

A New Paradigm for Care Coordination of Patients with Diabetes Mellitus: Linkage and Application Strategies to Available Resources between the Hospital and the Community

• Lee HY

• KMID: 2526191
• DOI: http://doi.org/10.4093/jkd.2021.22.2.134

Abstract

Diabetes Mellitus is a chronic disease that can be fatal to high-risk patients infected with the coronavirus. Many diabetic patients have been treated in a hospital setting. The coronavirus era is driving new approaches to how to manage diabetes. We belong to the community and a more therapeutic and supportive environment will make us healthier. Many resources are available in communities, but they are not utilized to their full extent because patients are treated in a traditional way, mostly at a hospital or clinic. Therefore, patient care is often redundant and segmented, and sometimes patients do not receive the simple and cost-effective care they need. Care coordination and an integrated approach could be one solution to these problems. Patients and doctors should be aware of the availability of hospital-based home healthcare and integrated healthcare services from community health centers that provide high-quality at-home care. A continuous health education program using health information technology could be a good way to increase diabetic patients’ compliance with self-care, especially medication compliance, therapeutic meals, and daily exercise.

Keyword

Case management; Community health services; Delivery of health care; integrated; Diabetes mellitus; Home care services; House calls; Home care services; hospital-based

Reference

1. World Health Organization. Introducing the global diabetes compact. Available from:. https://www.who.int/publications/m/item/introducing-the-global-diabetes-compact. (updated 2021 Apr 8).

2. Korean Diabetes Association. Diabetes fact sheet 2020. Available from:. https://www.diabetes.or.kr/pro/news/admin.php?category=A&code=admin&number=1972&mode=view. (updated 2020 Oct 15).

3. Korea Disease Control and Prevention Agency. Chronic disease prevention and management: hypertention and diabetes registry and management. Available from:. https://kdca.go.kr/contents.es?mid=a20303020200. (updated 2021 Apr 15).

4. Korea Disease Control and Prevention Agency. Korea National Health and Nutrition Examination. Main results of chronic disease survey. Available from:. https://knhanes.kdca.go.kr/knhanes/sub01/sub01_05_02.jsp#s5_03_01.

5. Korea Disease Control and Prevention Agency. Standard practice guidelines for hypertension diabetes registration management project in the year of 2021. Available from:. https://kdca.go.kr/board/board.es?mid=a20507020000&bid=0019&act=view&list_no=712282. (updated 2021 Feb 22).

6. Yun SK. Current status and problems of national diabetes care. J Korean Diabetes. 2020; 21:173–8.

7. Lee YK. Challenges in the management of diabetes in primary care. J Korean Diabetes. 2020; 21:161–5.

8. Ministry of Health and Welfare. Community-integrated care model, created by the region. Community integrated care (community care) initiative promotion plan. Available from:. https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=347345&page=1. (updated 2019 Jan 11).

9. Ministry of Health and Welfare. A guide to home visit health care in 2021. Available from:. https://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=0320&CONT_SEQ=364090. (updated 2021 Mar 15).

10. Ministry of Health and Welfare. To prevent complications from high blood pressure and diabetes, it is best to consistently take medicine and manage it regularly! Available from:. https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=349002. (updated 2019 Apr 11).

11. Medical Law. Home health care. Available from:. https://www.law.go.kr/법령/의료법시행규칙/(20170130,00458,20161229)/제24조. (updated 2010 Mar 19).

12. Health Insurance Review & Assessment Service. Finding pharmacy and clinic. Available from:. https://www.hira.or.kr/rd/hosp/getHospList.do.

13. Korean Home Healthcare Nurses Association. What is the Home Healthcare Service? Available from:. http://www.hcna.or.kr/sub2/2_1.php. Assessed on May 10, 2021.

14. Lim JY, Kim EJ, Choi KW, Lee JS, Noh WJ. Analysis of barriers and activating factors of visiting nursing in long-term care insurance. The Journal of the Korea Contents Association. 2012; 12:283–99.

15. Lim JY, Kim J. Expansion strategy of home visit nursing services of long-term care insurance. J Korean Acad Soc Home Care Nurs. 2020; 27:241–9.

16. Long-term Care Insurance Act. Announcement on standards for providing long-term care benefits and methods of calculating benefits. Available from:. https://www.law.go.kr/%ED%96%89%EC%A0%95%EA%B7%9C%EC%B9%99/%EC%9E%A5%EA%B8%B0%EC%9A%94%EC%96%91%EA%B8%89%EC%97%AC%20%EC%A0%9C%EA%B3%B5%EA%B8%B0%EC%A4%80%20%EB%B0%8F%20%EA%B8%89%EC%97%AC%EB%B9%84%EC%9A%A9%20%EC%82%B0%EC%A0%95%EB%B0%A9%EB%B2%95%20%EB%93%B1%EC%97%90%20%E A%B4%80%ED%95%9C%20%EA%B3%A0%EC%8B%9C. (updated 2021 May 1).

17. National Health Insurance. Long-term Care Insurance. Searching a long-term care institution. Available from:. https://www.longtermcare.or.kr/npbs/r/a/201/selectLtcoSrch.

18. Kim MJ, Kim HJ, Lee YS. A study on strengthening primary health care in the community. Korean Local Government Review. 2020; 22:1–19.

19. Ministry of Health and Welfare. The guideline for the chronic disease management of primary care in 2021: a pilot project (revised). Available from:. https://www.mohw.go.kr/react/jb/sjb0406vw.jsp?PAR_MENU_ID=03&MENU_ID=030406&page=1&CONT_SEQ=364061. (updated 2021 Mar 12).

20. Korea Health Promotion Institute. Participating clinic in our neighborhood. Available from:. https://www.khealth.or.kr/ncd/townJoinClinic/tjcList.do?menuId=MENU01084.

21. Cardio-cerebrovascular Disease Prevention and Management Act. Available from:. https://www.law.go.kr/법령/심뇌혈관질환의예방및관리에관한법률. (updated 2020 Sep 12).

22. G-health. Health promotion: cardio-cerebrovascular disease prevention and management program. Available from:. https://www.g-health.kr/portal/bbs/selectBoardArticle.do?bbsId=U00322&nttId=381801&menuNo=200406&lang=&searchCndSj=&searchCndCt=&searchWrd=&pageIndex=1&vType=Z1. (updated 2020 Apr 16).

23. G-health. Find a health institution: detailed search for medical institutions. Available from:. https://www.g-health.kr/portal/health/pubHealthSearch/list.do?bbsId=U00198&menuNo=200452.

24. Gangnam-gu Public Health Center. The first treatment. Available from:. https://health.gangnam.go.kr/content/376/view.do?mid=6-375-T&cid=&lang=ko. (updated 2020 Jun 5).

25. Gangnam-gu Public Health Center. Visiting health care service. Available from:. https://health.gangnam.go.kr/content/559/view.do?mid=419-559&lang=ko. (updated 2021 Mar 3).

26. Korea Health Promotion Institute. Public health center mobile healthcare project. Available from:. https://www.khealth.or.kr/board?menuId=MENU00864&siteId=null.