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.
Highlights
The global burden of diabetes had increased significantly since 1990
This study showed that medication adherence rates among those in CRMHDP more rapidly increased after the enrollment compared with the control groups and that the increased adherence rates among CRMHDP-enrollees were maintained during the followup period
The CRMHDP-enrollees were significantly less likely to be hospitalized by diabetes-specific complications than the control groups, after adjusting confounding variables like gender, age, economic status, health insurance type and medication adherence rates at baseline
Summary
The global burden of diabetes had increased significantly since 1990. In 2017, global prevalence and death of diabetes mellitus 476.0 million and 1.37 million, with a projection. According to Tricco et al [10], patient-mediated quality improvement strategies like patient self-management education and reminder service were better than provider-centered interventions strategies emphasize audit and feedback, clinician education and financial incentives In this regard, both physician-centered strategies without considerable work burden and patient mediated strategies would have been more effective in chronic care management in primary care settings. The Korean Centers for Disease Control and Prevention (KCDC) created a Community based Registration and Management for Hypertension and Diabetes mellitus Project (CRMHDP) in primary care settings for the elderly. The project began on 1 July 2009 in Gwangmyeong City This project was designed by taking account of the socio-psychological and behavioral characteristics among the elderly and busy primary care environment in Korea. This study aimed to examine how CRMHDP in Gwangmyeong(GM) city, started in 2009, influenced the medication compliance as an evaluation indicator of intermediate outcome and hospitalization rates related to complications of type 2 diabetes mellitus (Type 2 DM) among elderly patients as an evaluation indicator of long-term outcome, comparing with control groups
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
