Treatment Gap in the National Health-screening Program in Korea: Claim-based Follow-up of Statin Use for Sustained Hypercholesterolemia.
Participation in a screening program by itself may not improve clinical outcomes. Treatment gaps in the program may limit its full benefit. We evaluated statin prescription rates for subjects with sustained hypercholesterolemia to assess the treatment gaps in the National Health Screening Program (NHSP) in Korea. A retrospective, random cohort was established among National Health Insurance Corporation (NHIC) members. Finally, we examined 465,499 individuals who attended the NHSP from 2003 to 2010 without any history of dyslipidemia, statin prescription, or hospitalization for cardiovascular events until the end of 2002. The subsequent statin prescription rates were identified from the NHIC medical service claim database from 2003 to 2011. Descriptive data and odds ratio from multivariate logistic analyses on statin prescription rates and the corresponding correlations were evaluated. The NHSP detected 114,085 (24.5%) cases of newly diagnosed hypercholesterolemia. However, only 8.6% of these received statin prescription within 6 months of diagnosis. For cases of sustained hypercholesterolemia determined in the next screening visit by the NHSP, the statin prescription rate increased, but only to 12.2%. Statin prescriptions were more common among females, older individuals, and hypertension or diabetes patients. Furthermore, the statin prescription rates had increased over the study period. The NHSP exhibited low statin prescription rate which has been improving. For the NHSP to be effective, it would be worthwhile to decrease the gap between the diagnosis of hypercholesterolemia and the following treatment.
Cancer Policy Branch, National Cancer Control Research Institute, National Cancer Center, Goyang, Korea.
Eunmi
E
Ahn
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea. ; Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Korea. ; JW Lee Center for Global Medicine, and College of Medicine, Seoul National University, Seoul, Korea.
Dong Wook
DW
Shin
Cancer Policy Branch, National Cancer Control Research Institute, National Cancer Center, Goyang, Korea.
Hyung-kook
HK
Yang
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Jae Moon
JM
Yun
Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea.
So Hyun
SH
Chun
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Beomseok
B
Suh
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea. ; Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Hyejin
H
Lee
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea. ; Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Ki Young
KY
Son
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea. ; Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Korea.
BeLong
B
Cho
D000328:Adult; D002908:Chronic Disease; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiovascular Diseases; Cholesterol; Hypercholesterolemia; Prevention; Statins