- Continuity of Care of Patient with Diabetes and Its Affecting Factors in Korea.
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Chai Hyun Yoon, Sin Jae Lee, Sooyoung Choo, Ok Ryun Moon, Jae Hyun Park
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J Prev Med Public Health. 2007;40(1):51-58.
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DOI: https://doi.org/10.3961/jpmph.2007.40.1.51
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 Abstract
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- OBJECTIVES
The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. METHODS: We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. RESULTS: The average continuity of care in the entire population of 1,498,327 patients was 0.89+/-0.17 as calculated by MFPC and 0.92+/-0.16 by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. CONCLUSIONS: The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.
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Summary
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Citations
Citations to this article as recorded by  - Continuity of care and hospitalization frequency for ambulatory care-sensitive conditions after hearing-disability onset: a retrospective cohort study
Zhaoyan Piao, Heekyung Choi, Boyoung Jeon, Euna Han
Scientific Reports.2024;[Epub] CrossRef - Analysis of Continuity of Care and Its Related Factors in Diabetic Patients: A Cross-Sectional Study
Ji Yeh Shin, Ha Jin Kim, BeLong Cho, Yun Jun Yang, Jae Moon Yun
Korean Journal of Family Medicine.2022; 43(4): 246. CrossRef - The Role of Continuity of Care in the Management of Chronic Disease
Seung-Won Oh
Korean Journal of Family Medicine.2022; 43(4): 207. CrossRef - Trends in life expectancy among medical aid beneficiaries and National Health Insurance beneficiaries in Korea between 2004 and 2017
Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang
BMC Public Health.2019;[Epub] CrossRef - The effects of continuity of care on hospital utilization in patients with knee osteoarthritis: analysis of Nationwide insurance data
Boyoung Jung, Kyoung Hee Cho, Dong Hyun Lee, Soyoon Kim
BMC Health Services Research.2018;[Epub] CrossRef - Association between supplementary private health insurance and visits to physician offices versus hospital outpatient departments among adults with diabetes in the universal public insurance system
Chang Hoon You, Ji Heon Choi, Sungwook Kang, Eun-Hwan Oh, Young Dae Kwon, Iratxe Puebla
PLOS ONE.2018; 13(4): e0192205. CrossRef - The effect of continuity of care on the incidence of end-stage renal disease in patients with newly detected type 2 diabetic nephropathy: a retrospective cohort study
Yun Jung Jang, Yoon Soo Choy, Chung Mo Nam, Ki Tae Moon, Eun-Cheol Park
BMC Nephrology.2018;[Epub] CrossRef - Use of Western Medicine and Traditional Korean Medicine for Joint Disorders: A Retrospective Comparative Analysis Based on Korean Nationwide Insurance Data
Boyoung Jung, Sukjin Bae, Soyoon Kim, Gihyun Lee
Evidence-Based Complementary and Alternative Medicine.2017;[Epub] CrossRef - Effects of the Continuity of Care on Hospital Utilization : Convergence A Propensity Score Matching Analysis
Lee-Su Ahn
Journal of Digital Convergence.2015; 13(9): 323. CrossRef - The Quality of Medical Care Provided to Homeless Diabetes Patients in a General Hospital in Seoul, and the Prevalence of Diabetes Comorbidities
Sun Hee Beom, Moo Kyung Oh, Chul Woo Ahn
Korean Journal of Medicine.2014; 86(5): 585. CrossRef - Continuity of ambulatory care and health outcomes in adult patients with type 2 diabetes in Korea
Jae-Seok Hong, Hee-Chung Kang
Health Policy.2013; 109(2): 158. CrossRef - The Comparison of Health Status and Health Behavior among Hypertension Group, DM Group, and Hypertension DM Group for the Aged Provided with Customized Home Care Service by Visiting Nurses
Hee Kyoung Hyoung, Hyo-Soon Jang
Journal of Korean Academy of Community Health Nursing.2011; 22(1): 11. CrossRef - Educational disparities in quality of diabetes care in a universal health insurance system: evidence from the 2005 Korea National Health and Nutrition Examination Survey
Y. K. Do, K. N. Eggleston
International Journal for Quality in Health Care.2011; 23(4): 397. CrossRef - Group Classification on Management Behavior of Diabetic Mellitus
Sung-Hong Kang, Soon-Ho Choi
Journal of the Korea Academia-Industrial cooperation Society.2011; 12(2): 765. CrossRef - Continuity of Care for Elderly Patients with Diabetes Mellitus, Hypertension, Asthma, and Chronic Obstructive Pulmonary Disease in Korea
Jae Seok Hong, Hee Chung Kang, Jaiyong Kim
Journal of Korean Medical Science.2010; 25(9): 1259. CrossRef
- Alibi Verification and the PCR Method to Estimate the Source of Epidemic for a Few Notified Cases of S. sonnei.
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Sin Jae Lee, Dai ha Koh, Chai Hyun Yoon
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J Prev Med Public Health. 2005;38(4):420-424.
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A few culture-confirmed cases of S. sonnei have been notified from Korean hospitals. The source of epidemic can't be firmly determined in such cases because of the rarity of this illness in the local communities and the timing of the outbreaks. The objective of this study is to estimate the source of epidemic by investigating the patients' lifestyles. METHODS: Alibi verification was used to access the presumed source of the epidemic. PCR (Polymerase Chain Reaction) was used to rapidly detect the genes of Shigella in water specimens. RESULTS: The common lifestyle trait among the Shigellainfected patients was connected with Mt. Martyr in J city, Korea. The first patient's son had gone on a pilgrimage to Mt. Martyr with 41 friends and he had only eaten rice cakes on April 5th; the second patients had visited Mt. Martyr with their mother for a picnic on April 12th; the third patient had visited Mt. Martyr with 22 friends for a pilgrimage and the patient had only drunk holy water on April 13th. Therefore, the holy water of Mt. Martyr was reckoned to be the source of the epidemic. PCR detected the genes of Shigella two days before the S. sonnei was confirmed. CONCLUSION: The patients' lifestyles for 7 days before the onset of symptoms should be determined in terms of time, place and contacted people to find the source of infection when cases with food poisoning are seen in the hospital setting.
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- Socioeconomic Costs of Obesity for Korean Adults.
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Baek Geun Jeong, Ok Ryun Moon, Nam Soon Kim, Jae Heon Kang, Tae Ho Yoon, Sang Yi Lee, Sin Jae Lee
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Korean J Prev Med. 2002;35(1):1-12.
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To estimate the socioeconomic costs of obesity in Korea, 1998. METHODS: The 1998 National Health and Nutrition Examination Survey (1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM (non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF (Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. RESULTS: The direct costs of obesity were 2,126 billion~965 billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion~1,086 billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4,225 billion~2,050 billion Won, which corresponded to about 0.094% ~0.046% of GDP and 1.88%~0.91 of total health care costs in Korea. CONCLUSIONS: Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. Further studies are needed to caculate socioeconomic costs of obesity more exactly.
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- Increasing Prevalence of Obesity Related Disease for Koreans Associated with Overweight and Obesity.
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Nam Soon Kim, Ok Ryun Moon, Jae Heon Kang, Sang Yi Lee, Baek Geun Jeong, Sin Jae Lee, Tae Ho Yoon, Kyung Hwa Hwang
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Korean J Prev Med. 2001;34(4):309-315.
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To develop a better understanding of the relationship between weight status and the prevalence of obesity related diseases in the Korean population. METHODS: The 1998 Korean National Health and Nutrition Survey was used and 10,880 persons who had previously taken health examinations were selected for study. The Korean Society for the Study of Obesity's classification of weight status was used. Hypertension, diabetes mellitus, dyslipidemia, osteoarthritis, chronic heart disease, stroke were included as obesity related disease. A logistic regression model was developed to estimate the prevalence odds ratio by obesity class adjusted for demographic and socio-economic factors and we converted the odds ratio to a prevalence ratio using the base line prevalence of disease to aid in the interpretation of the ratios. RESULTS: The prevalence of obesity was 26.3% based on the KSSO classification (BMI> or =25). A graded increase in the prevalence ratio was observed with increasing severity of overweight and obesity for all health outcomes with the exception of chronic heart disease in men and stroke in both men and women. With normal weight individuals as the reference, for men who were younger than 50 years, the prevalence ratios were highest for hypertension BMI<23-25: 1.70(95% CI=1.41-2.05), 25 or =30: 4.83(95% CI=3.78-5.84). The prevalence ratios for dyslipidemia were as high as hypertension, but were lower than hypertension for diabetes mellitus and osteoarthritis. Prevalence ratios generally were greater in younger adults. The prevalence of having 2 or more obesity related diseases increased with weight status category, except in people who were older than 50 years. CONCLUSIONS: Based on results, obesity is an increasingly important health problem in Korea and the disease burden increases according to weight status. For Korean adults, the strongest relationship was seen between weight status and hypertension and dyslipidemia. In older people the impact of excess weight and obesity is stronger than that seen in younger people. Increased efforts in the study of obesity and prevention and treatment of obesity and obesity related disease are required.
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- Change of Medical Utilization Claims in Self-employees before and after the Economic Crisis in Korea.
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Sin Jae Lee, Ok Ryun Moon, Won Ki Jhang, Soon Ae Choi, Sang Yi Lee, Nam Soon Kim, Baek Geun Jeong
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Korean J Prev Med. 2001;34(1):28-34.
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To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. METHODS: The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 1 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. RESULTS: The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997. Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. CONCLUSIONS: Medical utilization in 1998 deceased in relation to 1997. Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu regio n' decreased more than the other regions.
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- Differences in Health Behaviors among the Social Strata in Korea.
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Tae Ho Yoon, Ok Ryun Moon, Sang Yi Lee, Baek Geun Jeong, Sin Jae Lee, Nam Sun Kim, Won Ki Jhang
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Korean J Prev Med. 2000;33(4):469-476.
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To analyze differences in health behaviors among the social strata in Korea by using the 1995 National Health and Health Behavior Survey Data. METHODS: Study participants numbered 2,352 men and 1,016 women aged between 15-64 years old, with housewives, students and non-waged family workers excluded. Health behaviors in this study were defined according to the recommendations of the Alameda 7 study. The measure of health behaviors was based on the Health Practices Index(HPI; 0-5 range, with the exclusion of snacking between meals and regularly eating breakfast) developed by the Alameda County research. The significance of the relationship between social strata and HPI was assessed by considering the adjusted means from the multi-variate model. RESULTS: For men, incidence rates of never having smoked, no/moderate use of alcohol, regular exercise, and regular 7-8 hours sleep per night were higher in the upper social strata. Meanwhile, for women, incidence rates of never having smoked, no/moderate use of alcohol, appropriate weight, regular exercise, and regular 7-8 hours sleep per night were higher in the upper strata. HPI varied significantly among social strata in both sexes (p<0.001), a result which held true when adjusted for age, education, income, social insurance type, marital status and region. CONCLUSIONS: Health behaviors assessed by Health Practices Index(HPI) varied significantly among social strata for both sexes. Therefore, the existing gap in health behaviors among social strata can be corrected more effectively by target oriented health promotional activities.
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- The State of the Art of Preventive Medicine in North Korea With Reference to the Content Analysis of a Medical Textbook.
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Sang Gu Yi, Ok Ryun Moon, Sin Jae Lee, Jung chul Kim, Wen Yong, Piao Song Lin
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Korean J Prev Med. 2000;33(3):373-382.
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The most frequently cited health related slogan in North Korea is that socialistic medicine is preventive medicine. It implies that North Korea puts preventive medicine at the operational center of its national health care system. This study aimed at examining and comparing preventive medicine practices in North Korea with those of South Korea. METHODS: Efforts have been made to obtain a textbook for analysis its contents. Many people have iassisted in the study by joining the interview. Some of these people are as follows: a former professor of PyongYang Medical School, NK physicians living in South Korea, WHO staffs, diplomatic officials, etc. The major items of analysis consisted of industrial medicine and hygiene, nutrition, school health, epidemiology, health statistics and heath policy & management. RESULTS: Public health philosophy is finely rooted and well integrated in the operation of the North Korean national health care system, particularly in the area of industrial medicine and hygiene. Preventive medicine with a strong health surveillance system spanning a number of broad social organizations is a major tool to improve the health of the people in North Korea. The emphasis on preventive medicine has a close relationship with the 'Juche Philosophy' and the shortage of pharmaceuticals and medical equipment. To cope with the shortage problem, North Korean health workers are encouraged to grow medicinal herbs. We have found that they put little effort into teaching newly emerging diseases, such as AIDS, VDT syndrome, hazards of EMF, and agricultural chemical poisonings. Of the subjects of the preventive medicine text, 78.9% coincide with those of South Korean industrial health manuals and 34.2% with South Korean epidemiology texts. However, an absolute difference was found to exist between the heath policies and management systems. CONCLUSION: In North Korea, the concept of preventive medicine functions as the basic philosophic strategy of the national health care system. It differs greatly from the South Korean system in both practice and educational content. Its contribution to society is simply incomparable to that of South Korea. More communication and further study is called for in order to improve the preventive medicine practices in the future.
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