Abstract
Objectives
This study aimed to identify patients at higher risk for regional disengagement from health services using the Patient-centered Relevance Index (P-RI).
Methods
This nationwide retrospective cohort study analyzed the relationship between the P-RI and individual patient characteristics, including medical conditions and healthcare utilization patterns. The National Health Insurance Service claims database was used to characterize healthcare utilization by 3,046,914 patients with DM from 2017 to 2020.
Results
As compared to the mild condition group, all other groups had a lower P-RI. Significant differences were observed among the groups with P-RI lower by 16.5%, 14%, 13%, 0.4%, and 0.6% in the repeated inpatient treatment (β = −0.165, P < 0.001), complication (β = −0.141, P < 0.001), extended long-term care stay (β = −0.130, P < 0.001), comorbidity (β = −0.041, P < 0.001), and other (β = −0.058, P < 0.001) groups, respectively. Additionally, the P-RI was high among low-income and older patients with high acuity.
Discussion
South Korea's healthcare delivery system is not regionally self-sufficient. A relatively low P-RI in the high income and younger groups indicates healthcare access inequity. Therefore, a continuous management system that ensures uniform healthcare access needs to be established.
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References
Supplementary Material
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