The Effect of Chronic Disease Management Program on the Risk of Complications in Patients With Hypertension in Korea

Area of Science:

• Public Health
• Health Services Research
• Cardiovascular Medicine

Background:

• A chronic disease management program was initiated to decrease out-of-pocket expenses for patients with chronic conditions requiring regular clinic visits.
• This program incentivizes patients to attend the same clinic for managing hypertension or diabetes by reducing consultation fees.

Purpose of the Study:

• To evaluate the association between enrollment in a chronic disease management program and the incidence of major cardiovascular and renal complications in hypertensive patients.
• To analyze the impact of reduced out-of-pocket costs on patient adherence and subsequent health outcomes.

Main Methods:

• Utilized nationwide claims data from the National Health Insurance Service (2011-2018).
• Included patients newly diagnosed with hypertension between 2012 and 2014.
• Employed Cox proportional hazards models to assess the risk of acute myocardial infarction (MI), stroke, chronic kidney disease (CKD), and heart failure (HF) in relation to program participation.

Main Results:

• Out of 827,577 participants, 12.6% enrolled in the chronic disease management program.
• Program participants exhibited significantly lower hazard ratios for all studied complications compared to non-participants.
• Specific hazard ratios included MI (0.75), stroke (0.75), CKD (0.90), and heart failure (0.56).

Conclusions:

• Participation in the chronic disease management program is associated with a reduced likelihood of developing major complications in patients with hypertension.
• Findings suggest that increasing enrollment in such programs could improve health outcomes and reduce healthcare expenditures for chronic disease management.
• The program's financial incentives appear effective in encouraging consistent care, potentially leading to better disease control.