Effectiveness of Community-based Case Management for Patients with Hypertension

Abstract

Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertensionon their health status and medical service utilization. Methods: This study was a secondary analysis ofdata collected for a larger study of chronic disease management in 2008 using the National Health InsuranceCorporation database. A total of 12,944 patients who received case management for hypertension were includedin this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use,and non-use groups according to the amount of medical service utilization. To compare the medical service utilization,a control group was selected randomly. The data were analyzed through descriptive statistics, McNemartest, and ANOVA. Results: All the subgroups displayed significant differences in blood pressure, self-management,social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medicalexpense of the over-use group. Conclusion: This finding suggests that there is a need to re-examine why patientsoveruse medical services and to supplement specific strategies for encouraging appropriate medical service utilization,and enhancing case management efforts for the over-use group.