Impact of a Primary Health Care Chronic Diseases Management Pilot Program

Abstract

Considerable efforts have been made to prevent and manage hypertension and diabetes, but the prevalence of these diseases has not changed significantly over the past 10 years. Hypertension and diabetes are chronic conditions requiring continuous treatment and management. Controlling blood pressure and blood sugar levels can prevent life-threatening complications and a deterioration in the quality of life. Community-centered primary health care is characterized by inclusiveness and continuous contact. Well-established primary health care services can reduce the number of unnecessary emergency room visits, hospitalizations, and medical tests, and therefore minimize unnecessary medical expenses. However, the number of patients treated for mild chronic diseases at large hospitals has increased, with a concomitant decrease in the proportion of outpatient clinic visits (41.6% in 2007 vs. 37.8% in 2016). Thus, there is a clear need to strengthen primary health care, including for the treatment of chronic diseases. To establish a chronic diseases management system based on local clinics, the Ministry of Health and Welfare of Korea launched a pilot chronic diseases management program aimed at increasing patient acceptance of local primary health care. The program was implemented in 2014, 2016, and 2019. This review examines the short-term impact of the pilot program with respect to the prevention and management of hypertension and diabetes.

Association Between Hypertension Management Education and Multiple Healthy Behaviors: A Cross-Sectional Study

“…Participants not engaged in economic activity were likely to adopt multiple healthy behaviors (OR = 1.16, 95% CI: 1.14-1. 19). The higher the participants' monthly household income, the more likely they were to adopt multiple healthy behaviors (middle-high income, OR = 1.05, 95% CI: 1.02-1.08; high-income, OR = 1.12, 95% CI: 1.09-1.16).…”

“…19,20 Based on periodic monitoring, management education (such as nutrition and exercise), and counseling for HTN and diabetes patients, the Korean government reinforced disease management albeit lacking in terms of medical and drug treatment, had improved continuous treatment rate of the aforementioned diseases. 19,20 In line with the government's plan to increase the HTN treatment rate, HTN management education encourages patients to engage in self-care and disease management, 21,22 allowing themselves to be proactive participants in the treatment process. 23 Through this initiative, individuals with HTN can learn strategies to manage their conditions and live healthy lives.…”

Effect of Practicing Health Behaviors on Unmet Needs among Patients with Chronic Diseases: A Longitudinal Study

“…Hypertension and diabetes are the most common chronic diseases in South Korea. The primary chronic disease management pilot project, which was based on the Chronic Care Model (CCM), to provide comprehensive community-oriented prevention services for these two diseases, has been carried out since 2014 [26]. Although this project has achieved results such as increased continuity of care, increased primary healthcare utilization, and improved clinical outcomes for participants, the limitations include low rate of education completion, low enrollment rate of patients under 65 years of age, and insufficient role establishment of participating medical institutions [27].…”

Digital Health Technology-Based Patient-Centered Seamless Care Model for Chronic Disease Management after Cancer Treatment

“…In South Korea, projects linking local clinics and community-based healthcare resources are being conducted at the national level. For example, the health information exchange (HIE) pilot project is establishing an electronic transmission/reception system for patient medical records [ 6 , 7 ], the primary care chronic disease management (PCDM) pilot project is laying the foundations for a comprehensive chronic disease management system based on local clinics [ 6 ], and the personal health records (PHR) project is building a health management platform by standardizing, integrating, and relating personal medical information [ 8 ].…”