Abstract
Dyslipidemia is a risk factor for atherosclerotic cardiovascular disease and requires proactive management. This study aimed to investigate the association between care continuity and the outcomes of patients with dyslipidemia. We conducted a retrospective cohort study on patients with dyslipidemia by employing the Korea National Health Insurance claims database during the period 2007–2018. The Continuity of Care Index (COCI) was used to measure continuity of care. We considered incidence of atherosclerotic cardiovascular disease as a primary outcome. A Cox's proportional hazards regression model was used to quantify risks of primary outcome. There were 236,486 patients newly diagnosed with dyslipidemia in 2008 who were categorized into the high and low COC groups depending on their COCI. The adjusted hazard ratio for the primary outcome was 1.09 times higher (95% confidence interval: 1.06–1.12) in the low COC group than in the high COC group. The study shows that improved continuity of care for newly-diagnosed dyslipidemic patients might reduce the risk of atherosclerotic cardiovascular disease.
Highlights
Dyslipidemia is a risk factor for atherosclerotic cardiovascular disease and requires proactive management
We identified patients newly diagnosed with dyslipidemia, which was coded as E78.0 ~ E78.9 according to the International Classification of Diseases, 10th version (ICD-10)[27], that made at least two ambulatory visits during the one year after the index date, and at least four visits during the first three years[16,28,29]
The study population included 236,486 patients, of which 53.8% were in the high continuity of care (COC) group and 46.2% were in the low COC group
Summary
Dyslipidemia is a risk factor for atherosclerotic cardiovascular disease and requires proactive management. The study shows that improved continuity of care for newly-diagnosed dyslipidemic patients might reduce the risk of atherosclerotic cardiovascular disease. Dyslipidemia refers to imbalance in the levels of one or more kinds of lipids such as total cholesterol, low-density lipoprotein cholesterol, triglycerides and high-density lipoprotein cholesterol in the b lood[1], and is a well-known risk factor for atherosclerotic cardiovascular disease (ASCVD)[2,3]. To reduce obstacles to treatment for silent chronic diseases like dyslipidemia, the role of medical staff can be significant[12] In this regard, the existing literature suggests that continuity of care (COC) between health providers and patients in chronic conditions might improve clinical outcomes[13,14,15,16]. It was hypothesized that a high COC would be related with positive clinical outcomes in dyslipidemic patients
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