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건강보험 청구자료를 이용한 진료 연속성이 당뇨 관련 예방 가능 입원에 미치는 영향 분석: 중·고령군을 중심으로

Effects of Continuity of Care on Diabetes-Related Avoidable Hospitalizations among Middle- and Old-Aged Patients: Analysis of National Health Insurance Claims Data

보건행정학회지 2019년 29권 3호 p.277 ~ 287
김보아 ( Kim Bo-Ah ) - 서울대학교 보건대학원 보건학과

Abstract


Background: Diabetes is known as one of the most important ambulatory care sensitive conditions. This study purposed to assess the status of continuity of care (COC) and diabetes-related avoidable hospitalizations (DRAHs) of a group of middle- and old-aged patients and to observe the relationship of the two elements by the two age groups.

Methods: This study utilized the National Health Insurance Service’s National Sample Cohort data and the subjects are diabetes patients of 45 and over, classified into two groups of ‘middle-aged’(45?64 years) and ‘old-aged’(≥65 years) patients. The dependent variable was DRAHs, which was defined in accordance with the definition of the Organization for Economic Cooperation and Development “Health Care Quality Indicators” project. COC, as an independent variable, is measured by the COC index in this study. Two-part model (multi-variate and multi-level analyses) was utilized.

Results: Factors associated with the status and the number of DRAHs differed by each age group. Meanwhile, the two-part model showed that higher COC was associated with a lower risk of preventable hospitalizations in both middle- and old-aged groups.

Conclusion: Study findings can provide health policy insights and implications in order to strengthen the primary care system for further improvement of diabetes management, especially for middle- and old-aged groups.

키워드

Diabetes-related avoidable hospitalizations; Continuity of care; Middle- and old-aged patients; Primary care; Older people
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