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Jeonghoon Ha  (Ha J) 1 Article
Clinical Care/Education
Impact of Continuous Care on Health Outcomes and Cost for Type 2 Diabetes Mellitus: Analysis Using National Health Insurance Cohort Database
Ji Hyun Nam, Changwoo Lee, Nayoung Kim, Keun Young Park, Jeonghoon Ha, Jaemoon Yun, Dong Wook Shin, Euichul Shin
Diabetes Metab J. 2019;43(6):776-784.   Published online October 21, 2019
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  • 14 Web of Science
  • 11 Crossref
AbstractAbstract PDFPubReader   

The objective of the study was to determine the impact of continuous care on health outcomes and cost of type 2 diabetes mellitus (T2DM) in Korea.


A nationwide retrospective, observational case-control study was conducted. Continuity of treatment was measured using Continuity of Care (COC) score. Information of all patients newly diagnosed with T2DM in 2004 was retrieved from the National Health Insurance database for the period of 2002 to 2013. The study examined 2,373 patients after applying exclusion criteria, such as for patients who died from conditions not related to T2DM. Statistical analyses were performed using frequency distribution, simple analysis (t-test and chi-squared test), and multi-method analysis (simple linear regression, logistic regression, and survival analysis).


The overall COC score was 0.8±0.24. The average incidence of diabetic complications was 0.39 per patient with a higher COC score, whereas it was 0.49 per patient with a lower COC score. In both survival and logistic analyses, patients who had high COC score were significantly less likely to have diabetic complications (hazard ratio, 0.69; 95% confidence interval, 0.54 to 0.88). The average medical cost was approximately 3,496 United States dollar (USD) per patient for patients with a higher COC score, whereas it was 3,973 USD per patient for patients with a lower COC score during the 2006 to 2013 period, with a difference of around 477 USD, which is statistically significant after adjusting for other factors (β=−0.152).


Continuity of care for diabetes significantly reduced health complications and medical costs from patients with T2DM.


Citations to this article as recorded by  
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    Quynh-Anh Le Ho Thi, Peter Pype, Johan Wens, Huy Nguyen Vu Quoc, Anselme Derese, Wim Peersman, Nhon Bui, Huyen Nguyen Thi Thanh, Tam Nguyen Minh
    BMC Public Health.2024;[Epub]     CrossRef
  • Application of continuing nursing intervention on wound infection and ulcers in patients with diabetic foot: A meta‐analysis
    Xu‐Xiang Li, Jing Xu, Juan Chen, Feng Gao, Qing‐Ju Wang, Shi‐Hu Yang
    International Wound Journal.2024;[Epub]     CrossRef
  • Impact of the family doctor system on the continuity of care for diabetics in urban China: a difference-in-difference analysis
    Xinyi Liu, Luying Zhang, Wen Chen
    BMJ Open.2023; 13(2): e065612.     CrossRef
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    Eunkyung Han, Wankyo Chung, Antonio Trujillo, Joel Gittelsohn, Leiyu Shi
    BMC Health Services Research.2023;[Epub]     CrossRef
  • Association between initial continuity of care status and diabetes-related health outcomes in older patients with type 2 diabetes mellitus: A nationwide retrospective cohort study in South Korea
    Hyun Woo Jung, Woo-Ri Lee
    Primary Care Diabetes.2023; 17(6): 600.     CrossRef
  • Relationship between continuity of care and clinical outcomes in patients with dyslipidemia in Korea: a real world claims database study
    Juhee Lee, Eunyoung Choi, Eunjung Choo, Siachalinga Linda, Eun Jin Jang, Iyn-Hyang Lee
    Scientific Reports.2022;[Epub]     CrossRef
  • Association Between Team-Based Continuity of Care and Risk of Cardiovascular Diseases Among Patients With Diabetes: A Retrospective Cohort Study
    Kam Suen Chan, Eric Yuk Fai Wan, Weng Yee Chin, Esther Yee Tak Yu, Ivy Lynn Mak, Will Ho Gi Cheng, Margaret Kay Ho, Cindy Lo Kuen Lam
    Diabetes Care.2022; 45(5): 1162.     CrossRef
  • Personal continuity of GP care and outpatient specialist visits in people with type 2 diabetes: A cross-sectional survey
    Anne Helen Hansen, May-Lill Johansen, Dylan A. Mordaunt
    PLOS ONE.2022; 17(10): e0276054.     CrossRef
  • Clinical Study Using Healthcare Claims Database
    Jin-Su Park, Chan Hee Lee
    Journal of Rheumatic Diseases.2021; 28(3): 119.     CrossRef
  • Effects of continuity of care on health outcomes among patients with diabetes mellitus and/or hypertension: a systematic review
    Kam-Suen Chan, Eric Yuk-Fai Wan, Weng-Yee Chin, Will Ho-Gi Cheng, Margaret Kay Ho, Esther Yee-Tak Yu, Cindy Lo-Kuen Lam
    BMC Family Practice.2021;[Epub]     CrossRef
  • Young-onset type 2 diabetes in South Korea: a review of the current status and unmet need
    Ye Seul Yang, Kyungdo Han, Tae Seo Sohn, Nam Hoon Kim
    The Korean Journal of Internal Medicine.2021; 36(5): 1049.     CrossRef

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