Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.
Sci Rep. 2021 Feb 18;11(1):4077. doi: 10.1038/s41598-021-83596-0.
Unnecessary surgery could be prevented through continuity of care (COC). The present study aimed to investigate the relationships between COC, surgery and cost associated with chronic shoulder pain. We used the Health Insurance Review and Assessment Service national patient sample (HIRA-NPS) in 2017. A total of 1717 patients were included. Bice-Boxerman Continuity of Care Index was used as the indicator for measuring the COC. Occurrence of surgery, associated costs, and direct medical costs were analysed. Logistic regression, a two-part model with recycled predictions and generalized linear model with gamma distribution were used. The majority of patients were 40-65 years old (high COC: 68.4%; low COC: 64.4%). The odds ratio (OR) for surgery was 0.41 in the high-COC group compared to the low COC group (95% CI, 0.20 to 0.84). Direct medical cost was 14.09% (95% CI, 8.12% to 19.66%) and 58.00% lower in surgery cost (95% CI, 57.95 to 58.05) in the high-COC group. Interaction with COC and shoulder impingement syndrome was significant lower in direct medical cost (15.05% [95% CI, 1.81% to 26.51%]). High COC was associated with low medical cost in patients diagnosed with chronic shoulder pain.
通过连续性护理（COC）可以预防不必要的手术。本研究旨在调查 COC、手术与慢性肩痛相关成本之间的关系。我们使用了 2017 年的健康保险审查和评估服务国家患者样本（HIRA-NPS）。共纳入 1717 名患者。Bice-Boxerman 连续性护理指数用于衡量 COC。分析了手术的发生、相关成本和直接医疗成本。使用逻辑回归、具有循环预测的两部分模型和具有伽马分布的广义线性模型。大多数患者年龄在 40-65 岁（高 COC：68.4%；低 COC：64.4%）。与低 COC 组相比，高 COC 组手术的优势比（OR）为 0.41（95%CI，0.20 至 0.84）。与低 COC 组相比，高 COC 组的直接医疗费用降低了 14.09%（95%CI，8.12%至 19.66%），手术费用降低了 58.00%（95%CI，57.95 至 58.05）。COC 与肩峰下撞击综合征之间的交互作用在直接医疗费用方面显著降低（15.05%[95%CI，1.81%至 26.51%]）。在诊断为慢性肩痛的患者中，高 COC 与较低的医疗费用相关。
