Greater continuity of care reduces hospital admissions in patients with hypertension: An analysis of nationwide health insurance data in Korea, 2011-2013

- We investigate the association between continuity of care and hospital admission.
- Greater continuity of care will decrease risk of hospital admission in hypertension patients.
- Increasing medication possession ratio will decrease risk of hospital admission.
- We report the need for a healthcare delivery system that promotes continuity of care.

ObjectivesTo measure the association between time-dependent COC and recurrent hospital admissions in patients with hypertension.Data sourcesKorean National Health Insurance Claims Database (KNHI), between 2011 and 2013.MethodsWe used Korean National Health Insurance Claims Database (KNHI) during 2011-2013 to evaluate the association between continuity of care and hospital admission in adult patients with hypertension. We performed a recurrent event survival analysis analyzing the effect of COC on hospital admissions via Cox proportional hazard regression analysis.ResultsThe adjusted risk of hospital admission for individuals with less COC (COC index <0.75) increased 42% (HR 1.42; 95% CI, 1.10-1.83) relative to the reference group (COC index ≥ 0.75). Relative to individuals with a medication possession ratio (MPR) of ≥0.75, the adjusted hazard ratio for hospital admission was 2.09 (95% CI, 1.31-3.35) for those with an MPR of 0.00-0.24, 2.10 (95% CI, 1.30-3.39) for those with an MPR of 0.25-0.49, and 1.40 (95% CI, 0.82-2.39) for those with an MPR of 0.50-0.74. After 12 months, the cumulative incidence of hospital admissions was 0.42% for those with less COC and 0.25% for those with greater COC.ConclusionsGreater COC was associated with a decreased risk of hospital admission in patients with hypertension.