Greater continuity of care reduces hospital admissions in patients with hypertension: An analysis of nationwide health insurance data in Korea, 2011-2013

Objectives: To measure the association between time-dependent COC and recurrent hospital admissions in patients with hypertension. Data sources: Korean National Health Insurance Claims Database (KNHI), between 2011 and 2013. Methods: We used Korean National Health Insurance Claims Database (KNHI) during 2011-2013 to evaluate the association between continuity of care and hospital admission in adult patients with hypertension. We performed a recurrent event survival analysis analyzing the effect of COC on hospital admissions via Cox proportional hazard regression analysis. Results: The adjusted risk of hospital admission for individuals with less COC (COC index <0.75) increased 42% (HR 1.42; 95% CI, 1.10-1.83) relative to the reference group (COC index ≥ 0.75). Relative to individuals with a medication possession ratio (MPR) of ≥0.75, the adjusted hazard ratio for hospital admission was 2.09 (95% CI, 1.31-3.35) for those with an MPR of 0.00-0.24, 2.10 (95% CI, 1.30-3.39) for those with an MPR of 0.25-0.49, and 1.40 (95% CI, 0.82-2.39) for those with an MPR of 0.50-0.74. After 12 months, the cumulative incidence of hospital admissions was 0.42% for those with less COC and 0.25% for those with greater COC. Conclusions: Greater COC was associated with a decreased risk of hospital admission in patients with hypertension.