본문 바로가기
KERD
논문KCI 등재

만성질환자의 상용치료원 이용과 복약순응도 간의 관계

The Association between having a Usual Source of Care and Adherence to Medicines in Patients with Chronic Diseases

3

조회

0

다운로드

17

인용

0

참고문헌

키워드

주제분류약학

초록

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as “not taking the medicines that were prescribed for treating chronic disease” or “not following the direction for medication”. Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience nonadherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

Abstract

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as “not taking the medicines that were prescribed for treating chronic disease” or “not following the direction for medication”. Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience nonadherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

참고문헌 (29)

  1. World Health Statistics, "WHO", World Health Organization, ~ (2010)
  2. Korea National Health Insurance Service, Health Insurance Service and Assessment Service, "National health insurance statistictial year book 2011" (2011)
  3. 허순임, "우리나라 고혈압 환자와 당뇨병 환자의 미충족 의료 수준과 관련 요인", 보건행정학회지, 21(1), pp.1~22 (2011), 한국보건행정학회
  4. Cramer JA, "Medication compliance and persistence:terminology and definitions", Value in Health, 11(1), pp.44~47 (2008)
  5. Park EJ, "Medication compliance: factors and interventions", Health-Welf Policy Forum, pp.82~91 (2011)
  6. The analysis on medical expenditure and health outcomes by continuity of care- experiene of hypertension and diabetes, "Park C", Health Insurance Review and Assessment Service, ~ (2010)
  7. Development of evalation indicators for Antihypertensive drugs, "Jang SM", Health Insurance Review and Assessment Service;, ~ (2008)
  8. 박종혁, "고혈압약 투약을 시작한 장애인의 투약 순응도와 이에 영향을 미치는 요인", 예방의학회지, 40(3), pp.249~258 (2007), 대한예방의학회
  9. 홍재석, "우리나라 성인 2형 당뇨환자에서의 외래 투약 순응도와 관련요인 분석", 보건행정학회지, 20(2), pp.128~143 (2010), 한국보건행정학회
  10. 허순임, "미충족 의료 경험과 보건의료체계에 대한 인식", 보건경제와 정책연구, 22(1), pp.59~89 (2016), 한국보건경제정책학회
  11. 김성옥, "고혈압과 당뇨병 노인의 복약순응도와 이에 영향을 미치는 요인", 한국임상약학회지, 21(2), pp.81~89 (2011), 한국임상약학회
  12. Lee EK, "Analysis of Medication Compliance and Polypharmacy for the Old Diabetic Patients", J Korean Soc Health Educ Promot, 17(1), pp.81~93 (2000)
  13. Lee EK, "Analysis of Factors Affecting Medication Compliance of Outpatients", Korean J Quality Health Care, 9(2), pp.164~175 (2002)
  14. Chang E, "Factors associated with having a usual source of care in an ethnically diverse sample of Asian American adults", Med Care, 52(9), pp.833~841 (2014)
  15. Bodenheimer T, "Patient self-management of chronic disease in primary care", Jama, 288(19), pp.2469~2475 (2002)
  16. Centers for Disease Control Prevention, "Vital signs: prevalence, treatment, and control of hypertension--United States, 1999-2002 and 2005-2008", MMWR. Morbidity and mortality weekly report, 2011(60), pp.103~ (2011)
  17. DeVoe JE, "Usual source of care as a health insurance substitute for US adults with diabetes?", Diabetes Care, 32(6), pp.983~989 (2009)
  18. He J, "Factors associated with hypertension control in the general population of the United States", Arch Intern Med, 162(9), pp.1051~1058 (2002)
  19. Moy E, "Access to hypertensive care: effects of income, insurance, and source of care", Arch Intern Med, 155(14), pp.1497~1502 (1995)
  20. 김재용, "우리나라 당뇨병환자의 외래이용 지속성이 건강결과 (health outcome)와 의료비에 미치는 영향: 건강보험자료 분석결과", Diabetes and Metabolism Journal, 30(5), pp.377~387 (2006), 대한당뇨병학회
  21. 김진현, "상용 치료원(Regular Source of Care) 보유가 예방서비스 제공 및 질병관리에 미치는 영향", Korean Journal of Family Medicine, 28(4), pp.278~285 (2007), 대한가정의학회
  22. 홍두호, "고혈압·당뇨병 신규 환자 발견 이후 지역사회 협력을 통한 등록관리가 치료순응도 및 혈압 및 혈당 조절에 미치는 영향", 농촌의학.지역보건, 33(3), pp.316~323 (2008), 한국농촌의학.지역보건학회
  23. Spatz ES, "Beyond insurance coverage: Usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003-2006 National Health and Nutrition Examination Survey", Am Heart J, 160(1), pp.115~121 (2010)
  24. Kerse N, "Physician-patient relationship and medication compliance: a primary care investigation", Ann Fam Med, 2(5), pp.455~461 (2004)
  25. Basie analysis report on Korea Health Panel 2012 National Health Insurance Service, "Seo NG", Korea Instit Health and Soc Welf, ~ (2014)
  26. 임지혜, "한국의료패널 자료를 이용한 만성질환자의 미충족 의료 현황 분석", 보건과 사회과학, (34), pp.237~256 (2013), 한국보건사회학회
  27. Schoen C, "Toward higher-performance health systems: adults’ health care experiences in seven countries, 2007", Health Aff, 26(6), pp.w717~w734 (2007)
  28. Mainous III AG, "Relationship between continuity of care and diabetes control: evidence from the Third National Health and Nutrition Examination Survey", Am J Public Health, 94(1), pp.66~70 (2004)
  29. An analysis on health care utilization among users of Chronic Diseases Management Program in primary care, "Baek J", National Health Insurnace Service, ~ (2015)

관련 논문AI추천

이 간행물의 다른 논문 (9건)