The Effect of Chronic Disease Management Program on the Risk of Complications in Patients With Hypertension in Korea.

Autor:	Lee SA; BigData Strategy Department, National Health Insurance Service, Wonju, Korea., Park H; HIRA Research Institute, Health Insurance Review and Assessment Service, Wonju, Korea.; Department of Public Health, Graduate School, College of Medicine, Yonsei University, Seoul, Korea., Kim W; Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea., Song SO; Division of Endocrinology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea., Lim H; Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, Goyang, Korea., Chun SY; Department of Research and Analysis, National Health Insurance Service Ilsan Hospital, Goyang, Korea. cedric6909@gmail.com.
Jazyk:	angličtina
Zdroj:	Journal of Korean medical science [J Korean Med Sci] 2022 Aug 08; Vol. 37 (31), pp. e243. Date of Electronic Publication: 2022 Aug 08.
DOI:	10.3346/jkms.2022.37.e243
Abstrakt:	Background: A chronic disease management program was implemented in April 2012 to lower out-of-pocket costs for repeat visits to the same clinic. The aim of this study was to investigate the association between participating in this program and the onset of complications among patients with hypertension using whole-nation claims data. Methods: We used National Health Insurance Service data (2011-2018) and patients with newly detected hypertension from 2012 to 2014 were selected. Chronic disease management program reduces the out-of-pocket expenses of consultation fee from 30% to 20% when patients enroll in this program by agreeing to visit the same clinic for the treatment of hypertension or diabetes. As the dependent variable, acute myocardial infarction (MI), stroke, chronic kidney disease (CKD), and heart failure (HF) were selected. For analysis, cox proportional hazards model was used. Results: Total participants were 827,577, among which 102,831(12.6%) subjects participated in the chronic disease management. Participants of the chronic disease management program were more likely to show lower hazard ratios (HRs) than those of non-participants in terms of all complications (MI: HR, 0.75; 95% confidence interval [CI], 0.68-0.82; stroke: HR, 0.75; 95% CI, 0.72-0.78; CKD: HR, 0.90; 95% CI, 0.85-0.96; HF: HR, 0.56; 95% CI, 0.52-0.61). Conclusion: The results showed that participants of the chronic disease management program were less likely to have hypertension complications compared to non-participants. Enhancing the participation rate may be related to better outcomes and reducing medical expenses among patients with chronic diseases. Competing Interests: The authors have no potential conflicts of interest to disclose. (© 2022 The Korean Academy of Medical Sciences.)
Databáze:	MEDLINE
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