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.
Because improved medication adherence can produce better health outcomes for diabetes patients and also save national healthcare resources, government-sponsored healthcare policies to improve medication adherence among newly diagnosed diabetes patients are urgently required.
Background and ObjectivesInformation about disease incidence is indispensable for the active prevention and control of acute myocardial infarction (AMI). The purpose of this study was to provide basic information for the establishment of policy related to AMI by examining the long-term trends in incidence of AMI.Subjects and MethodsThis study identified the trend in disease incidence during between 1997 and 2007 using the Korean National Health Insurance Database that includes AMI {the 10th International Classification of Disease (ICD-10) code: I21, I22, I23, I250, I251} as a primary or secondary disease.ResultsThe attack and incidence rates for AMI in 2007 were 118.4 and 91.8 per 100,000 persons, respectively, and the rates more than doubled for the 11 years. Both rates were higher among males than females and increased more in the older age groups. Incidence cases accounted for most of the total attack cases every year; however, in recent years the proportion of relapse cases was on the rise. The case fatality rate was highest (14.5%) in 2000, and declined rapidly to 9.8% in 2007. The case fatality rate was higher among females than males and the older age groups; in particular, female patients ≥65 years of age had the highest fatality rate.ConclusionThis study showed that AMI has been on the rise in Korea for 11 years. Therefore, the establishment of policy for intensive control of the incidence of AMI is necessary by building a continuous monitoring and surveillance system.
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