Dataset Information

Management of Chronic Disease and Hospitalization Due to Diabetes among Type 2 Diabetes Patients in Korea: Using the National Sample Cohort Data 2002?2013.

ABSTRACT: To prevent negative outcomes for diabetes patients, developing self-management skills is imperative. This study aimed to examine the association between management of chronic disease (MCD), which mainly involves educating patients about their chronic diseases for obtaining self-management skills and hospitalization due to diabetes among type 2 diabetes patients in Korea. Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013 were used. A total of 54,031 type 2 diabetes patients were included in the study. If patients received the MCD within 1 year from the onset of diabetes, we categorized them as "MCD received patients" We reclassified these groups into five groups: "non-receiving", "1?3 times", "4?6 times", "7?9 times" and "10?12 times" The dependent variable of this study was hospitalization due to diabetes. Cox proportional hazard regression was used. Of the patients, 86.2% (n = 46,571) did not received the MCD within the 1 year from the onset of diabetes. The number of MCDs received increased and the hazard ratio (HR) for hospitalization due to diabetes decreased; particularly, patients who received MCD 10?12 times per annum showed the lowest HR for hospitalization due to diabetes compared to patients in the MCD non-received group (1?3 times per annum: HR: 0.81, p = 0.0001; 4?6 times per annum: HR: 0.82, p = 0.0248; 7?9 times per annum: HR: 0.75, p = 0.0054; 10?12 times per annum: HR: 0.61, p < 0.0001). Considering the importance of raising self-managing diabetes skills, the findings can aid in determining the outcomes of the MCD program.

SUBMITTER: Lee SA

PROVIDER: S-EPMC6266696 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Management of Chronic Disease and Hospitalization Due to Diabetes among Type 2 Diabetes Patients in Korea: Using the National Sample Cohort Data 2002⁻2013.

Lee Sang Ah SA Kim Woorim W Oh Sarah Soyeon SS Yang Jieun J Jang Jieun J Park Eun-Cheol EC

International journal of environmental research and public health 20181113 11

To prevent negative outcomes for diabetes patients, developing self-management skills is imperative. This study aimed to examine the association between management of chronic disease (MCD), which mainly involves educating patients about their chronic diseases for obtaining self-management skills and hospitalization due to diabetes among type 2 diabetes patients in Korea. Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013 were used. A total of 54,031 type 2 dia ...[more]

PMID: 30428539

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Project description:BackgroundDiarrheal illness is a major reason for hospitalization, but data on consequent acute kidney injury (AKI) are sparse.ObjectiveTo determine the incidence of AKI in infectious and non-infectious diarrheal illness requiring hospitalization and to identify correlates and outcomes of diarrhea-associated AKI.DesignUsing data from the 2012 National Inpatient Sample (NIS), we created a cohort of patients with a primary diagnosis of diarrheal illness. Diarrheal illness, disease correlates, and AKI were defined by ICD-9 diagnosis codes. We used logistic regression with backward variable selection to determine factors independently associated with AKI in infectious and non-infectious diarrheal illness, as well as to determine the association of AKI with in-hospital mortality. We used generalized linear models to assess differences in length of stay and costs of hospitalization.Main measuresThe primary outcome was AKI in hospitalized diarrheal illness. Secondary outcomes were in-hospital mortality, length of stay, and cost of hospitalization associated with AKI.Key resultsOne in ten adults hospitalized with diarrheal illness experienced AKI, with higher incidence rates in older adults. Chronic kidney disease (CKD) and hypertension were associated with increased odds of AKI (all diarrhea OR 4.81, 95% CI 4.52 to 5.12 and OR 1.33, 95% CI 1.27 to 1.40, respectively). AKI in diarrheal illness was associated with substantial increase in mortality (OR 5.05, 95% CI 4.47 to 5.72), length of stay (mean increase 1.7 days [95% CI 1.6 to 1.8]), and cost of hospitalization (mean increase $4411 [95% CI 4023 to 4800]).ConclusionAcute kidney injury is common and consequential among patients hospitalized for diarrheal illness. Persons with CKD and hypertension are the most susceptible, possibly due to diminished renal reserve and exacerbating effects of treatment with diuretics and renin-angiotensin-aldosterone system blockers. Proactive management of these unique pharmacologic and physiologic factors is necessary to prevent AKI in this vulnerable population.

Project description:This study investigated trends in the prescription of antidiabetic medications for patients with type 2 diabetes, focusing on changing patterns of prescriptions and the cost of drugs during the last 10 years. Retrospective data on patients with type 2 diabetes aged 30 years or older were analyzed using information from the National Health Information Database collected by the National Health Insurance Service in Korea from January 2002 to December 2013. We identified patients with type 2 diabetes who had at least one service claim in each year during the study period. The prescribing information was collected and fixed-dose combination tablets were counted as each of their constituent classes. The total number of adults with type 2 diabetes who were treated using antidiabetic agents increased from 0.87 million in 2002 to 2.72 million in 2013 in Korea. Among antidiabetic medications in 2002, sulfonylurea (SU) was the most commonly used agent (87.2%), and metformin was the second (52.9%). However, in 2013, the use of metformin increased to 80.4% of the total antidiabetic prescriptions. The use of dipeptidyl peptidase-4 (DPP-4) inhibitor increased remarkably after release in late 2008 and composed one-third of the market share with 1 million prescriptions (38.4%) in 2013. Among the prescriptions for monotherapy, only 13.0% were metformin in 2002, but the amount increased to 53.2% by 2013. In contrast, the use of SU declined dramatically from 75.2% in 2002 to 30.6% in 2013. Dual and triple combinations steadily increased from 35.0% and 6.6% in 2002 to 44.9% and 15.5% in 2013, respectively. In 2013, SU with metformin (41.7%) and metformin with DPP-4 inhibitor (32.5%) combination were most frequently prescribed. The total antidiabetic medication cost increased explosively from U.S. $70 million (82.5 billion won) in 2002 to U.S. $4 billion (480 billion won) in 2013.The use of antidiabetic agents and their costs have been increasing steadily. Metformin is the most commonly used drug recently. The use of DPP-4 inhibitor increased significantly over the past decade, whereas the use of SU decreased. However, SUs still remain the most commonly prescribed second-line agents with metformin in 2013.

Dataset Information

Management of Chronic Disease and Hospitalization Due to Diabetes among Type 2 Diabetes Patients in Korea: Using the National Sample Cohort Data 2002?2013.

Publications

Management of Chronic Disease and Hospitalization Due to Diabetes among Type 2 Diabetes Patients in Korea: Using the National Sample Cohort Data 2002⁻2013.

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