Kang Hee-Chung, Hong Jae-Seok
Department of Health Care Policy Research, Korea Institute for Health and Social Affairs (KIHASA), Sejong City 30147, Korea.
Division of Health Administration and Healthcare, Cheongju University College of Health and Medical Sciences, Cheongju 28503, Korea.
Healthcare (Basel). 2022 Feb 9;10(2):334. doi: 10.3390/healthcare10020334.
(1) Background: Although the beneficial impacts of primary care on patients' health outcomes have been reported, it is still difficult to limit patients' herd behavior in seeking tertiary or large hospital services in South Korea. The purpose of this study was to examine whether the use of primary care clinics was longitudinally beneficial for mild diabetes. (2) Methods: Using claims data from the National Health Insurance (NHI) program, this population-based retrospective cohort study compared health outcomes over a 4-year period from 2011 to 2015 by type of health care institution as a usual source of care in diabetic patients who were newly diagnosed in 2011, i.e., without any diagnosis between 2005 and 2010. (3) Results: Compared to those attending hospitals, general hospitals (GHs), or tertiary general hospitals (TGHs), patients who visited primary clinics were more likely to experience better health outcomes such as the lower risk of hospitalization and death. (4) Conclusions: These results provide additional evidence that higher-value from primary care clinics would be highly expected for early and mild type 2 diabetics. Promoting the Informed, patient-centered decision toward primary care clinics would contribute to improving the value of the healthcare delivery system.
(1) 背景:尽管已有报道称初级保健对患者健康结局有有益影响,但在韩国,仍难以限制患者寻求三级或大型医院服务的从众行为。本研究的目的是检验使用初级保健诊所对轻度糖尿病患者是否具有长期益处。(2) 方法:利用国民健康保险(NHI)计划的理赔数据,这项基于人群的回顾性队列研究,将2011年新诊断的糖尿病患者(即在2005年至2010年期间无任何诊断记录)在2011年至2015年的4年期间,按作为常规医疗服务机构类型比较了健康结局。(3) 结果:与就诊于医院、综合医院(GHs)或三级综合医院(TGHs)的患者相比,就诊于初级诊所的患者更有可能获得更好的健康结局,如住院和死亡风险更低。(4) 结论:这些结果提供了额外证据,表明对于早期和轻度2型糖尿病患者,初级保健诊所有望带来更高价值。促进向初级保健诊所做出明智、以患者为中心的决策,将有助于提高医疗服务体系的价值。