Performance of a Community-based Noncommunicable Disease Control Program in Korea: Patients 65 Years of Age or Older

Abstract

Background In Korea, the Korean Community-based Noncommunicable Disease Prevention and Control Program (KCNPC) was implemented in 2012 for the management of patients with chronic diseases. Nineteen primary care clinics, public health centers, and education and consulting centers (ECCs) participated in the implementation of this program. This study assessed the effectiveness of this chronic disease control model by comparing mortality rate and the incidence of complications between patients participating in the KCNPC program and a control group. Methods Using data from the National Health Insurance Service and data from hypertension and diabetes patients registered with 19 ECCs between January 1, 2010 and December 31, 2012, hypertension and diabetes patients who had been treated at a clinic were selected. The final analysis included 252,900 patients, with the intervention group and control group having 126,450 patients each. Survival for the two groups was analyzed using the Kaplan-Meier method. Complications were analyzed using the Cox proportional hazards model. Results The 5-year survival rate in the intervention group (0.88) was higher than that in the control group (0.86). Cox proportional hazards analysis showed that the intervention group had lower risk for mortality (0.84; 95% confidence interval [CI], 0.82–0.86) compared to the control group. Hospitalization due to complications and the proportional risk of hospitalization were also lower in the intervention group. Conclusion The KCNPC model for prevention and control of chronic disease in Korea was found to be effective for hypertension and diabetes patients. Therefore, the KCNPC will be necessary to strengthen the capabilities of local communities, primary medical institutions, and individuals for prevention and control of chronic disease. Expanding the efficient prevention and control policies of the KCNPC to a nationwide scale may be effective as has been demonstrated through limited implementation in some regions.

Exploring Disparities for Obesity in Korea Using Hierarchical Age-Period-Cohort Analysis With Cross-Classified Random Effect Models

“…In South Korea, urban-rural differences in obesity trends reverse following industrialization and are exacerbated by rural challenges. Despite the implementation of several nationwide health initiatives targeting chronic disease prevention and management, such as the Korean community-based Registration and Management Program for Hypertension and Diabetes, 16 the Non-communicable Diseases Prevention and Control Program, 17 and the Primary Care Project, 18 healthcare service utilization still shows significant variation with urbanicity, indicated by the National Health Insurance Service. 16 Therefore, to effectively address this urban-rural gap in obesity rates, tailored interventions for rural areas, including telehealth and web-based programs, are essential.…”

Trends in the Quality of Primary Care and Acute Care in Korea From 2008 to 2020: A Cross-sectional Study

“…In the United States, the AHRs for ACSC in 2014 were 1426 per 100 000 people, and this rate has been decreasing since 2005 [ 26 ]. In Korea, national programs such as the NQAP for chronic diseases [ 20 ], the Chronic Disease Care System program [ 27 ], the Korean Community-based Noncommunicable Disease Prevention and Control program [ 28 ], and the Pilot Project for Primary Care Chronic Disease Management [ 29 ] have been implemented to encourage the public to manage chronic diseases. According to the NQAP report on chronic diseases, the medication adherence rate in 2019 was 91.9% for both hypertension and diabetes, reflecting slight increases since 2011, when the rates were 88.9% and 88.0%, respectively [ 20 ].…”

Effects of Diabetes Quality Assessment on Diabetes Management Behaviors Based on a Nationwide Survey

“…The positive relationship between the proportion of hospitals with good diabetes management and walking activity can be explained by the health education provided by medical personnel to diabetic patients to have a good lifestyle. Several large-scale chronic disease management programs implemented in the South Korea Program [ 8 , 9 ] reported that education and consulting improved disease management. However, since the proportion of hospitals with good diabetes management in our study did not show an association between smoking rate and obesity rate, it is possible that the proportion of hospitals with good diabetes management may proxy other characteristics at the regional level.…”

“…To improve diabetes complication management, various projects have been implemented in South Korea, including the Korean community-based Registration and Management Program for Hypertension and Diabetes [ 7 ], the Non-communicable Diseases Prevention and Control Program [ 8 ], and the Primary Care Project [ 9 ]. Health Insurance Review and Assessment (HIRA) evaluates treatment outcomes in clinics and hospitals for chronic diseases such as hypertension, diabetes, and asthma, and provides financial incentives to primary care clinics and hospitals with good outcomes.…”