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社区干预对韩国基层医疗诊所 2 型老年糖尿病患者药物治疗依从性和住院的影响。

Effects of Community-Based Interventions on Medication Adherence and Hospitalization for Elderly Patients with Type 2 Diabetes at Primary Care Clinics in South Korea.

机构信息

Department of Preventive Medicine, College of Medicine, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea.

Public Health Medical Office, Chung-Nam National University Hospital, Daejeon 35015, Korea.

出版信息

Int J Environ Res Public Health. 2021 Mar 25;18(7):3396. doi: 10.3390/ijerph18073396.

Abstract

Korean Disease Control and Prevention Agency launched Control and Prevention Community-based Registration and Management for Hypertension and Diabetes mellitus Project (CRMHDP) in Gwangmyeong city, 2009. This project has provided incentives on both patient and physician and has made private clinics and Public Health Center (PHC) in a community collaborate for effective chronic disease management among elderly people. This study aimed to evaluate the effects of CRMHDP on medication compliance and hospitalization due to diabetes-specific complications. The retrospective cohort study design was based on data of Korean National Health Insurance (KNHI) with 2 control areas (A & B) with usual primary care service similar to Gwangmyeong city regarding community health resources. The data on the study subjects were examined for the following 5 years since the baseline point. Medication adherence rates of CRMHDP-enrollees after the project was significantly higher than two control groups. For the hospitalization due to any complications, adjusted hazard ratio in the intervention group, compared to the control group A and B, were 0.76 (95% Confidence Interval: 0.65-0.78) and 0.52 (95% Confidence Interval 0.41-0.78), respectively. CRMHDP could successful in improving the management of type 2 diabetes mellitus among elderly people in South Korean primary care settings.

摘要

韩国疾病控制与预防机构于 2009 年在光州市启动了高血压和糖尿病控制和预防社区注册和管理项目(CRMHDP)。该项目为患者和医生提供了激励措施,并使私人诊所和社区内的公共卫生中心(PHC)合作,以有效管理老年人的慢性病。本研究旨在评估 CRMHDP 对药物依从性和因糖尿病特定并发症导致的住院的影响。这项回顾性队列研究设计基于韩国国家健康保险(KNHI)的数据,其中 2 个对照区(A 和 B)在社区卫生资源方面与光州市的常规初级保健服务相似。自基线点以来,对研究对象的数据进行了以下 5 年的检查。项目实施后,CRMHDP 参与者的药物依从率明显高于两个对照组。对于因任何并发症导致的住院,与对照组 A 和 B 相比,干预组的调整后危害比分别为 0.76(95%置信区间:0.65-0.78)和 0.52(95%置信区间:0.41-0.78)。CRMHDP 可以成功改善韩国初级保健环境中老年人 2 型糖尿病的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f004/8059144/989363d7a64c/ijerph-18-03396-g001.jpg

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