Cargando…

The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence

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:...

Descripción completa

Detalles Bibliográficos
Autores principales: Han, Eunkyung, Chung, Wankyo, Trujillo, Antonio, Gittelsohn, Joel, Shi, Leiyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080744/
https://www.ncbi.nlm.nih.gov/pubmed/37024901
http://dx.doi.org/10.1186/s12913-023-09232-x
_version_ 1785020979327533056
author Han, Eunkyung
Chung, Wankyo
Trujillo, Antonio
Gittelsohn, Joel
Shi, Leiyu
author_facet Han, Eunkyung
Chung, Wankyo
Trujillo, Antonio
Gittelsohn, Joel
Shi, Leiyu
author_sort Han, Eunkyung
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09232-x.
format Online
Article
Text
id pubmed-10080744
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-100807442023-04-08 The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence Han, Eunkyung Chung, Wankyo Trujillo, Antonio Gittelsohn, Joel Shi, Leiyu BMC Health Serv Res Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-09232-x. BioMed Central 2023-04-06 /pmc/articles/PMC10080744/ /pubmed/37024901 http://dx.doi.org/10.1186/s12913-023-09232-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Han, Eunkyung
Chung, Wankyo
Trujillo, Antonio
Gittelsohn, Joel
Shi, Leiyu
The associations of continuity of care with inpatient, outpatient, and total medical care costs among older adults with urinary incontinence
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 Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080744/
https://www.ncbi.nlm.nih.gov/pubmed/37024901
http://dx.doi.org/10.1186/s12913-023-09232-x
work_keys_str_mv AT haneunkyung theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT chungwankyo theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT trujilloantonio theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT gittelsohnjoel theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT shileiyu theassociationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT haneunkyung associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT chungwankyo associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT trujilloantonio associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT gittelsohnjoel associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence
AT shileiyu associationsofcontinuityofcarewithinpatientoutpatientandtotalmedicalcarecostsamongolderadultswithurinaryincontinence