Abstract
BackgroundThe Chronic Disease Care System (CDCS) has been implemented in Korea to encourage treatment continuity in chronic disease patients. This study investigated the effect of the introduction of the CDCS on health care costs and continuity of care in individuals with type 2 diabetes mellitus (T2DM).MethodsThe National Health Insurance data from August, 2010 to March, 2012 (pre-policy) and from May, 2012 to December, 2013 (post-policy) were used. Introduction of the CDCS was defined as the intervention. The intervention group consisted of T2DM patients participating in the program and the control group patients not participating in the program. The Difference-in-Differences (DID) method was used to estimate the differences in total health care costs for outpatient services and continuity of care between the intervention and the control group before and after the intervention period.ResultsImplementation of the CDCS was associated with decreased health care costs (β = − 46,877 Korean Won, P < 0.0001) and improved continuity of care (β = 0.0536, P < 0.0001) in the intervention group with adjustment for covariates.ConclusionFindings confirm an association between the adoption of the CDCS and reduced health care costs and improved continuity of care. The results reveal the potential benefits of reinforcing effective chronic disease management strategies in reducing health care costs and improving treatment continuity.
Highlights
The Chronic Disease Care System (CDCS) has been implemented in Korea to encourage treatment continuity in chronic disease patients
The control group had a higher proportion of individuals with disability and those diagnosed with diabetes related complications
In terms of health care costs, the coefficient of model 1 (β = − 47,523 Korean Won (KRW), P < 0.0001) and model 2 (β = − 46,877 KRW, P < 0.0001) were statistically significant. This implies a positive relationship between implementation of the CDCS and reduced health care costs for covered outpatient services
Summary
The Chronic Disease Care System (CDCS) has been implemented in Korea to encourage treatment continuity in chronic disease patients. This study investigated the effect of the introduction of the CDCS on health care costs and continuity of care in individuals with type 2 diabetes mellitus (T2DM). Considering the importance of providing proper disease management to enhance treatment quality and contain costs, the government of Korea introduced the Chronic Disease Care System (CDCS) program in 2012 [11]. The CDCS program aims to enhance care coordination by encouraging patients with T2DM or hypertension to designate a primary care clinic of their choice for continued care [12]. By voluntarily participating in the CDCS program, T2DM patients choose a preferred primary clinic and agree to consistently receive care from the selected institution. Health care providers are separately provided with incentives after assessment by the Health Insurance Review and Assessment Service (HIRA)
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