Young Soon Nam1, Kyoung Hee Cho2, Hee-Chung Kang3, Kwang-Sig Lee4, Eun-Cheol Park5. 1. Department of Quality Assessment, Health Insurance Review & Assessment Service, Republic of Korea. 2. Department of Public Health, Graduate School, Yonsei University, Republic of Korea; Institute of Health Services Research, College of Medicine, Yonsei University, Republic of Korea. 3. Institute for Health and Social Affairs, Health Security Research Division, Republic of Korea. 4. Institute of Health Services Research, College of Medicine, Yonsei University, Republic of Korea; Department of Preventive Medicine, College of Medicine, Yonsei University, Republic of Korea. 5. Institute of Health Services Research, College of Medicine, Yonsei University, Republic of Korea; Department of Preventive Medicine, College of Medicine, Yonsei University, Republic of Korea. Electronic address: ECPARK@yuhs.ac.
Abstract
OBJECTIVES: To measure the association between time-dependent COC and recurrent hospital admissions in patients with hypertension. DATA SOURCES: Korean National Health Insurance Claims Database (KNHI), between 2011 and 2013. METHODS: We used Korean National Health Insurance Claims Database (KNHI) during 2011-2013 to evaluate the association between continuity of care and hospital admission in adult patients with hypertension. We performed a recurrent event survival analysis analyzing the effect of COC on hospital admissions via Cox proportional hazard regression analysis. RESULTS: The adjusted risk of hospital admission for individuals with less COC (COC index <0.75) increased 42% (HR 1.42; 95% CI, 1.10-1.83) relative to the reference group (COC index≥0.75). Relative to individuals with a medication possession ratio (MPR) of ≥0.75, the adjusted hazard ratio for hospital admission was 2.09 (95% CI, 1.31-3.35) for those with an MPR of 0.00-0.24, 2.10 (95% CI, 1.30-3.39) for those with an MPR of 0.25-0.49, and 1.40 (95% CI, 0.82-2.39) for those with an MPR of 0.50-0.74. After 12 months, the cumulative incidence of hospital admissions was 0.42% for those with less COC and 0.25% for those with greater COC. CONCLUSIONS: Greater COC was associated with a decreased risk of hospital admission in patients with hypertension.
OBJECTIVES: To measure the association between time-dependent COC and recurrent hospital admissions in patients with hypertension. DATA SOURCES: Korean National Health Insurance Claims Database (KNHI), between 2011 and 2013. METHODS: We used Korean National Health Insurance Claims Database (KNHI) during 2011-2013 to evaluate the association between continuity of care and hospital admission in adult patients with hypertension. We performed a recurrent event survival analysis analyzing the effect of COC on hospital admissions via Cox proportional hazard regression analysis. RESULTS: The adjusted risk of hospital admission for individuals with less COC (COC index <0.75) increased 42% (HR 1.42; 95% CI, 1.10-1.83) relative to the reference group (COC index≥0.75). Relative to individuals with a medication possession ratio (MPR) of ≥0.75, the adjusted hazard ratio for hospital admission was 2.09 (95% CI, 1.31-3.35) for those with an MPR of 0.00-0.24, 2.10 (95% CI, 1.30-3.39) for those with an MPR of 0.25-0.49, and 1.40 (95% CI, 0.82-2.39) for those with an MPR of 0.50-0.74. After 12 months, the cumulative incidence of hospital admissions was 0.42% for those with less COC and 0.25% for those with greater COC. CONCLUSIONS: Greater COC was associated with a decreased risk of hospital admission in patients with hypertension.
Authors: Shirley Cohen-Mekelburg; Sameer D Saini; Sarah L Krein; Timothy P Hofer; Beth I Wallace; John M Hollingsworth; Julie P W Bynum; Wyndy Wiitala; Jennifer Burns; Peter D R Higgins; Akbar K Waljee Journal: JAMA Netw Open Date: 2020-09-01