한빛사논문
- 조회448
Ji Hye Huh 1, Serim Kwon 2, Gui Ok Kim 2, Bo Yeon Kim 3, Kyoung Hwa Ha 4, Dae Jung Kim 4
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
2Department of Quality Assessment, Health Insurance Review and Assessment Service, Wonju, Republic of Korea.
3Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju, Republic of Korea.
4Department of Endocrinology & Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
Corresponding authors: Kyoung Hwa Ha, and Dae Jung Kim
Abstract
Objective: This study examined the long-term effectiveness of the national diabetes quality assessment program (NDQAP) in diabetes.
Research design and methods: From the Health Insurance Review and Assessment Service database, 399,984 individuals with diabetes who visited a primary care clinic from 1 July 2012 to 30 June 2013 were included and followed up until 31 May 2021. The NDQAP included five quality assessment indicators: regular outpatient visits, continuity of prescriptions, regular testing of glycated hemoglobin and lipids, and regular fundus examination. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for diabetes complications and all-cause mortality by the achievement of quality assessment indicators.
Results: During the mean follow-up duration of 7.6 ± 1.8 years, 20,054 cases (5.0%) of proliferative diabetic retinopathy (PDR), 6,281 end-stage kidney diseases (ESKD; 1.6%), 1,943 amputations (0.5%), 9,706 myocardial infarctions (MIs; 2.4%), 26,975 strokes (6.7%), and 35,799 all-cause mortality (8.9%) occurred. Each achievement of quality assessment indicator was associated with a decreased risk of diabetes complications and all-cause mortality. Individuals who were managed in high-quality institutions had a lower risk of PDR (HR 0.82; 95% CI 0.80-0.85), ESKD (HR 0.77; 95% CI 0.73-0.81), amputation (HR 0.75; 95% CI 0.69-0.83), MI (HR 0.85; 95% CI 0.82-0.89), stroke (HR 0.86; 95% CI 0.84-0.88), and all-cause mortality (HR 0.96; 95% CI 0.94-0.98) than those who were not managed in high-quality institutions.
Conclusions: In Korea, the achievement of NDQAP indicators was associated with a decreased risk of diabetes complications and all-cause mortality.
논문정보
- Research article
- 2023년 07월 (BRIC 등록일 2023-08-03)
- 국내 연구진
- 의약학 > 응용의학
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