title: Effects of diabetic case management on knowledge, self-management abilities, health behaviors, and health service utilization for diabetes in Korea.
abstract: OBJECTIVE
  This study aimed to evaluate the effects of a case management program for diabetics, using a pre-post comparison design.
  
  
  METHODS
  The study population comprised 6007 diabetics who received case management intervention in 2006 and were sampled nationwide in Korea. Before and after the intervention, the study population answered questions regarding their knowledge of diabetes, self-management ability, and health behaviors. Body mass index (BMI) was also calculated. Healthcare service utilization for diabetes was extracted from health insurance claim data from 2005 to 2007.
  
  
  RESULTS
  The case management program significantly improved the study population's knowledge of diabetes and ability to self-manage nutrition, blood glucose monitoring, foot and oral care, and medications. This program also significantly changed the study population's health behaviors regarding smoking, alcohol drinking, and exercise, and BMI was positively affected. In the over-serviced subgroup, there was a significant decrease in the number of consultations (mean=7.0; SD=19.5) after intervention. Conversely, in the under-serviced subgroup, there was a significant increase in the number of consultations (mean=3.2; SD=7.9) and the days of prescribed medication (mean=66.4; SD=120.3) after intervention.
  
  
  CONCLUSIONS
  This study showed that the case management program led the study population to improve their knowledge, self-management ability, health behaviors, and utilization of health care. It is necessary in future studies to evaluate the appropriateness of healthcare usage and clinical outcome by using a control group to determine the direct effectiveness of this case management program.
authors.affiliation: Bigdata Steering Department, National Health Insurance Service, Seoul, Korea.
authors.forename: Soon Ae
authors.initials: SA
authors.lastname: Shin
authors.affiliation: Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, Korea. mubul@kku.ac.kr.
authors.forename: Hyeongsu
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, Korea.
authors.forename: Kunsei
authors.initials: K
authors.lastname: Lee
authors.affiliation: Health Sector Development, Western Pacific Region, WHO, Manila, Philippines.
authors.forename: Vivian
authors.initials: V
authors.lastname: Lin
authors.affiliation: Department of Public Health, School of Public Health & Human Biosciences, Faculty of Health Sciences, La Trobe University, Melbourne, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Public Health Administration, Hanyang Women's University, Seoul, Korea.
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D019090:Case Management; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012648:Self Care
keywords: Case management; Korea; diabetes; intervention