Factors affecting treatment compliance in new hypertensive patients in Korea

Abstract

This study aims to analyze continuity of care according to complications and examine the relationship between the continuity of care and health outcomes (hospitalization, emergency department visits, and complications) using data of new hypertensive patients from Korea's National Health Insurance Claims database. There were a total of 715,053 new hypertensive patients followed up for three years until 2011. Indices of continuity of care were Continuity of Care Index (COC), Modified, Modified Continuity Index (MMCI), and Most Frequent Provider Continuity (MFPC). The mean values of COC, MMCI, and MFPC were 0.79, 0.77, and 0.87, respectively, in new hypertensive patients with complications, and 0.80, 0.79, and 0.87, respectively, in those without complications. The factors affecting the continuity of care were sex, ambulatory care visits, number of providers, main medical institution, and Charlson's comorbidity score. Following analysis of the correlation between the treatment compliance and health outcomes, the low COC group had a higher association with hospitalization, the emergency department visit, and complications as compared with the high COC group. COC and medication adherence were associated with a reduction of hospitalization, emergency department visits, and complications. This indicates it would be mandatory to manage the patients' continuity of care.