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우리나라 성인 2형 당뇨환자의 외래진료 지속성과 관련요인 분석

Continuity of Ambulatory Care among Adult Patients with Type 2 Diabetes and Its Associated Factors in Korea

  • 홍재석 (건강보험심사평가원 심사평가정책연구소) ;
  • 김재용 (한림대학교 의과대학 사회의학교실) ;
  • 강희정 (건강보험심사평가원 심사평가정책연구소)
  • Hong, Jae-Seok (Health Insurance Review & Assessment Policy Institute, Health Insurance Review & Assessment Service, Republic of Korea) ;
  • Kim, Jai-Yong (Department of Social and Preventive Medicine, Hallym University College of Medicine, Republic of Korea) ;
  • Kang, Hee-Chung (Health Insurance Review & Assessment Policy Institute, Health Insurance Review & Assessment Service, Republic of Korea)
  • 발행 : 2009.06.30

초록

Background : Previous studies have reported that enhanced continuity of care prevented a sudden worsening in progress among chronic disease patients, and as a result was favorable for efficient spending of health care funds. This study aims to estimate the continuity of care of Korean with diabetes and to identify factors affecting the continuity of care. Methods : This study used the Korean National Health Insurance Claims Database which includes E11 (ICD-10) as a primary or secondary disease as of 2006. Study population is 1,160,725 type 2 diabetics (20-84 years). Continuity of Care Index (COC), Modified, Modified Continuity Index (MMCI), and Most Frequent Provider Continuity (MFPC) were used as indexes of continuity of care. Results : The continuity of care in the study population was $0.94{\pm}0.10$ as calculated by MMCI, $0.91{\pm}0.16$ as calculated by MFPC and $0.86{\pm}0.23$ as calculated by COC. The lower continuity of care was shown in the patients who were female, 65 and over years old, Medical Aid recipients, 13 times or more visitors, hospital users as main attending medical institution, patients experienced hospitalizations or comorbidities. Conclusion : The continuity of care for adult patients with type 2 diabetes was high in Korea, and showed variation according to patients' characteristics. This result provides empirical evidence for policymakers to develop or strengthen programs for managing patients showing low continuity of care.

키워드

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