Browse > Article

Relationship between Antihypertension Medication Adherence, Medical Utilizations, and Medical Expenditure Among Patients with Hypertension  

Kim, SeongOk (Health Insurance Policy Institute, National Health Insurance Service)
Jang, Sunmee (College of Pharmacy, Inje University)
Publication Information
YAKHAK HOEJI / v.57, no.5, 2013 , pp. 369-375 More about this Journal
Abstract
Objective: Using the Korean Health Panel data (KHP) of 2008 and 2009, this paper analyzed the effect of antihypertension medication adherence on the changes in medical service utilization and medical expenditure in the next year. Method: Through a face-to-face interview survey, KHP has provided an extensive data on demographic characteristics, medical utilizations behavior, medical expenditure and health behaviors of the targeted households and their members since 2008. KHP is recognized as highly accurate regarding medical expenditure in that it makes the target households to record 'Health diary' whenever they use healthcare service, which could minimize their cognitive bias or memory distortion. The 2010 KHP data was based on the interview from 6,432 households and 19,697 household members. Two part model was used to explore the effects of medication adherence on medical use (logistic regression analysis) and medical expenditures (OLS). Result: Our study result demonstrated that the 74.7% of the patients who strictly adhere to their medication in both years, in 2008 and in 2009, were likely to use inpatient service in 2010. This shows the noncompliant patients were in fact use emergency service less than the compliant patients. Conclusion: Based on our analysis, this paper concludes that the high medication adherence of hypertensive patients could contribute to reduce the emergency service use. Therefore it is highly recommendable for the Korean government and the insurer, NHIS, to actively invest in developing education and promotion program to improve medication adherence among hypertensive patients.
Keywords
medication adherence; hypertension; Modified Morisky Scale (MMS); Korean Health Panel (KHP);
Citations & Related Records
연도 인용수 순위
  • Reference
1 Barat, I., Andreasen, F. and Damsgaard, E M. : Drug therapy in the elderly: what doctors believe and patients actually do. Br. J. Clin. Pharmacol. 51, 615 (2001).   DOI
2 김진현 : 만성질환자의 복약순응도, 제2회 한국의료패널 학술세미나 자료집 (2010).
3 Vik, S. A., Maxwell, C. J., Hogan, D. B., Patten, S. B., Johnson, J. A. and Romonko-Slack, L. : Assessing medication adherence among older persons in community settings. Can. J. Clin. Pharmacol. 12, e152 (2005).
4 Sekura, R. and Paulson, G. G. : Using a Patient-Based Information Technology Approach for Solving Prescription Medication Non-Compliance (www.itaa.org/isec/events/ presentations/1154.ppt).
5 신현택, 오정미, 이숙향, 서옥경 등 : 약료학 개론, 도서출판 신일상사 (2000).
6 신현택, 손현순, 송인숙 : 우리나라 노인환자의 의약품사용 실태 및 문제점 분석과 대책 방향 (2005).
7 Elliott, R. A., Barber, N., Clifford, S., Horne, R. and Hartley, E. : The cost effectiveness of a telephone-based pharmacy advisory service to improve adherence to newly prescribed medicines. Pharm. World Sci. 30, 17 (2008).
8 선우덕, 송현종, 황나미, 강은정, 서영준, 김태일, 김동진 : 고령화 사회에서의 노인보건의료체계 구축방안, 한국보건사회연구원 (2005).
9 Park, J. H., Shin, Y., Lee, S. Y. and Park, J. H. : Antihypertensive drug medication adherence of people with disabilities and its affecting factors in Korea. J. Prev. Med. Public. Health 40, 249 (2007).   DOI
10 Sokol, M. C., McGuigan, K. A., Verbrugge, R. R. and Epstein, R. S. : Impact of medication adherence on hospitalization risk and healthcare cost. Med. Care 43, 521 (2005).   DOI
11 Hong, J. S. and Kang, H. C. : Relationship between oral antihyperglycemic medication adherence and hospitalization, mortality, and healthcare costs in adult ambulatory care patients with type 2 diabetes in South Korea. Medical Care 49, 378 (2011).
12 박찬미, 장선미, 장수현 등 : 치료지속성에 따른 의료비용 및 건강결과 분석, 건강보험심사평가원 (2010).
13 WHO : Adherence to long-term therapies-evidence for action (2003).
14 Korea Health Panel, http://www.khp.re.kr.
15 Yoo, T. W., Kim, S. W., Lee, I. G., Kim, M. Y. and Huh, B. R. : Concurrent validity of the Korean version of selfreported questionnaire. Korean J. Fam. Med. 16, 172 (1995).
16 Case Management Society of America, Chapter 7. Modified Morisky Scale, IN Case Management Adherence Guidelines version 1.0, (2004) June 1.
17 Korea Center for Disease Control, 2011 National Health and Nutrition Examination Survey, http://knhanes.cdc.go.kr.
18 김성원, 이인구, 김미영, 유태우, 허봉렬 : 복약 순응도에 관한 자가보고 설문의 한국어판 개발 및 타당도 조사. 가정의학회지 16, 172 (1995).
19 정혜주 : 개인 및 가구의 약제비 지출에 영향을 미치는 요인. 제3회 한국의료패널 학술대회 자료집 (2011).
20 황연희 : 세대별 의료비 지출에 영향을 미치는 요인 분석. 제3회 한국의료패널 학술대회 자료집 (2011).