인천광역시 의원기반 건강포인트제도가 고혈압ㆍ당뇨병환자의 지속치료에 미치는 영향

Abstract

Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetesmellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registeredgroup from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number ofclinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health InsuranceCorporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and definedabove 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logisticregression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regressionmodel, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higherOR in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertensionor type 2 diabetes mellitus.