The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence
Abstract Introduction Urinary incontinence is a significant health problem with considerable social and economic consequences among older adults. The objective of this study was to investigate the financial impact of continuity of care (CoC) among older urinary incontinence patients in South Korea....
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09232-x |
| _version_ | 1827970620131901440 |
|---|---|
| author | Eunkyung Han Wankyo Chung Antonio Trujillo Joel Gittelsohn Leiyu Shi |
| author_facet | Eunkyung Han Wankyo Chung Antonio Trujillo Joel Gittelsohn Leiyu Shi |
| author_sort | Eunkyung Han |
| collection | DOAJ |
| description | Abstract Introduction Urinary incontinence is a significant health problem with considerable social and economic consequences among older adults. The objective of this study was to investigate the financial impact of continuity of care (CoC) among older urinary incontinence patients in South Korea. Methods We used the NHIS-Senior cohort patient data between January 1, 2010, and December 31, 2010. Patients who were diagnosed with urinary incontinence in 2010 were included. Operational definition of CoC included referrals, number of providers, and number of visits. A generalized linear model (GLM) with γ-distributed errors and the log link function was used to examine the relationship between health cost and explanatory variables. Additionally, we conducted a two-part model analysis for inpatient cost. Marginal effect was calculated. Results Higher CoC was associated with a decrease in total medical cost (-0.63, P < .0001) and in outpatient costs (-0.28, P < .001). Higher Charlson Comorbidity Index (CCI) score was a significant predictor for increasing total medical cost (0.59, P < .0001) and outpatient cost (0.22, P < .0001). Higher CoC predict a reduced medical cost of $360.93 for inpatient cost (P = 0.044) and $23.91 for outpatient cost (P = 0.008) per patient. Conclusion Higher CoC was associated with decrease in total medical costs among older UI patients. Policy initiatives to promote CoC of older UI patients in the community setting could lead to greater financial sustainability of public health insurance in South Korea. |
| first_indexed | 2024-04-09T18:56:38Z |
| format | Article |
| id | doaj.art-ff4edddaccb54d229826966bf5bf934d |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-09T18:56:38Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-ff4edddaccb54d229826966bf5bf934d2023-04-09T11:11:36ZengBMCBMC Health Services Research1472-69632023-04-012311910.1186/s12913-023-09232-xThe associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinenceEunkyung Han0Wankyo Chung1Antonio Trujillo2Joel Gittelsohn3Leiyu Shi4Johns Hopkins Bloomberg School of Public HealthDepartment of Public Health Science, Graduate School of Public Health, Seoul National UniversityJohns Hopkins Bloomberg School of Public HealthJohns Hopkins Bloomberg School of Public HealthJohns Hopkins Bloomberg School of Public HealthAbstract Introduction Urinary incontinence is a significant health problem with considerable social and economic consequences among older adults. The objective of this study was to investigate the financial impact of continuity of care (CoC) among older urinary incontinence patients in South Korea. Methods We used the NHIS-Senior cohort patient data between January 1, 2010, and December 31, 2010. Patients who were diagnosed with urinary incontinence in 2010 were included. Operational definition of CoC included referrals, number of providers, and number of visits. A generalized linear model (GLM) with γ-distributed errors and the log link function was used to examine the relationship between health cost and explanatory variables. Additionally, we conducted a two-part model analysis for inpatient cost. Marginal effect was calculated. Results Higher CoC was associated with a decrease in total medical cost (-0.63, P < .0001) and in outpatient costs (-0.28, P < .001). Higher Charlson Comorbidity Index (CCI) score was a significant predictor for increasing total medical cost (0.59, P < .0001) and outpatient cost (0.22, P < .0001). Higher CoC predict a reduced medical cost of $360.93 for inpatient cost (P = 0.044) and $23.91 for outpatient cost (P = 0.008) per patient. Conclusion Higher CoC was associated with decrease in total medical costs among older UI patients. Policy initiatives to promote CoC of older UI patients in the community setting could lead to greater financial sustainability of public health insurance in South Korea.https://doi.org/10.1186/s12913-023-09232-xContinuity of careUrinary incontinenceHealth care costsPrimary health care |
| spellingShingle | Eunkyung Han Wankyo Chung Antonio Trujillo Joel Gittelsohn Leiyu Shi The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence BMC Health Services Research Continuity of care Urinary incontinence Health care costs Primary health care |
| title | The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence |
| title_full | The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence |
| title_fullStr | The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence |
| title_full_unstemmed | The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence |
| title_short | The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence |
| title_sort | associations of continuity of care with inpatient outpatient and total medical care costs among older adults with urinary incontinence |
| topic | Continuity of care Urinary incontinence Health care costs Primary health care |
| url | https://doi.org/10.1186/s12913-023-09232-x |
| work_keys_str_mv | AT eunkyunghan theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT wankyochung theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT antoniotrujillo theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT joelgittelsohn theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT leiyushi theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT eunkyunghan associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT wankyochung associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT antoniotrujillo associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT joelgittelsohn associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence AT leiyushi associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence |