title: Greater continuity of care reduces hospital admissions in patients with hypertension: An analysis of nationwide health insurance data in Korea, 2011-2013.
abstract: OBJECTIVE
  To measure the association between time-dependent COC and recurrent hospital admissions in patients with hypertension.
  
  
  METHODS
  Korean National Health Insurance Claims Database (KNHI), between 2011 and 2013.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  Greater COC was associated with a decreased risk of hospital admission in patients with hypertension.
authors.affiliation: Department of Quality Assessment, Health Insurance Review & Assessment Service, Republic of Korea.
authors.forename: Young Soon
authors.initials: YS
authors.lastname: Nam
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, Republic of Korea; Institute of Health Services Research, College of Medicine, Yonsei University, Republic of Korea.
authors.forename: Kyoung Hee
authors.initials: KH
authors.lastname: Cho
authors.affiliation: Institute for Health and Social Affairs, Health Security Research Division, Republic of Korea.
authors.forename: Hee-Chung
authors.initials: HC
authors.lastname: Kang
authors.affiliation: Institute of Health Services Research, College of Medicine, Yonsei University, Republic of Korea; Department of Preventive Medicine, College of Medicine, Yonsei University, Republic of Korea.
authors.forename: Kwang-Sig
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Institute of Health Services Research, College of Medicine, Yonsei University, Republic of Korea; Department of Preventive Medicine, College of Medicine, Yonsei University, Republic of Korea. Electronic address: ECPARK@yuhs.ac.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D015994:Incidence; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D010343:Patient Admission / Q000706:statistics & numerical data*; D010359:Patient Readmission; D056910:Republic of Korea / Q000453:epidemiology
keywords: Continuity of care; Hospital admission; Hypertension; Recurrent event survival analysis