Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea
Type 2 diabetes mellitus (T2DM) is a chronic disease that requires long-term therapy and regular check-ups to prevent complications. In this study, insurance claim data from the National Health Insurance Service (NHIS) of Korea were used to investigate insulin use in T2DM patients according to the e...
Gespeichert in:
| Veröffentlicht in: | PloS one 2019-03, Vol.14 (3), p.e0210159 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 3 |
| container_start_page | e0210159 |
| container_title | PloS one |
| container_volume | 14 |
| creator | Min, Kyoung Lok Koo, Heejo Choi, Jun Jeong Kim, Dae Jung Chang, Min Jung Han, Euna |
| description | Type 2 diabetes mellitus (T2DM) is a chronic disease that requires long-term therapy and regular check-ups to prevent complications. In this study, insurance claim data from the National Health Insurance Service (NHIS) of Korea were used to investigate insulin use in T2DM patients according to the economic status of patients and their access to primary physicians, operationally defined as the frequently used medical care providers at the time of T2DM diagnosis. A total of 91,810 participants were included from the NHIS claims database for the period between 2002 and 2013. The utilization pattern of insulin was set as the dependent variable and classified as one of the following: non-use of antidiabetic drugs, use of oral antidiabetic drugs only, or use of insulin with or without oral antidiabetic drugs. The main independent variables of interest were level of income and access to a frequently-visited physician. Multivariate Cox proportional hazards analysis was performed. Insulin was used by 9,281 patients during the study period, while use was 2.874 times more frequent in the Medical-aid group than in the highest premium group [hazard ratio (HR): 2.874, 95% confidence interval (CI): 2.588-3.192]. Insulin was also used ~50% more often in the patients managed by a frequently-visited physician than in those managed by other healthcare professionals (HR: 1.549, 95% CI: 1.434-1.624). The lag time to starting insulin was shorter when the patients had a low income and no frequently-visited physicians. Patients with a low level of income were more likely to use insulin and to have a shorter lag time from diagnosis to starting insulin. The likelihood of insulin being used was higher when the patients had a frequently-visited physician, particularly if they also had a low level of income. Therefore, the economic statuses of patients should be considered to ensure effective management of T2DM. Utilizing frequently-visited physicians might improve the management of T2DM, particularly for patients with a low income. |
| doi_str_mv | 10.1371/journal.pone.0210159 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2189139146</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A577309014</galeid><doaj_id>oai_doaj_org_article_fd8d6d16e7054023a75575be46f30b9d</doaj_id><sourcerecordid>A577309014</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-c542bd209aba0c08a052a119c65ef72a710a38c84614cfacf692d5b1ff0eaaa53</originalsourceid><addsrcrecordid>eNqNk11vFCEUhidGY2v1HxglMTF6sSsMM8zMjUnT-LGxSRNrvSVnGNhlw8IWGLX652V2p82O6YXhAnJ43hc4nJNlzwmeE1qRd2vXewtmvnVWznFOMCmbB9kxaWg-YzmmDw_WR9mTENYYl7Rm7HF2RHFdYEbxcfbnKmqjf0PUzqItxCi9DcgppG3ojbZIOT_EtbQxoJ86rlC82UqUo05DK6MMSHm3QXbnAAatJJgEDXIPVkgkDOhNQB1ESFF06fq0_cV5CU-zRwpMkM_G-SS7-vjh29nn2fnFp8XZ6flMsCaPM1EWedvluIEWsMA14DIHQhrBSqmqHCqCgdaiLhgphAKhkqorW6IUlgBQ0pPs5d53a1zgY94Cz0ndENqQgiVisSc6B2u-9XoD_oY70HwXcH7JwUctjOSqqzvWESYrXBY4p1CVZVW2smCK4rbpktf78bS-3chOpMR5MBPT6Y7VK750PzhLdiyvk8Gb0cC7616GyDc6CGkMWOn63b3rpmpYVSX01T_o_a8bqSWkB2irXDpXDKb8tEwuuMGkSNT8HiqNTm60SEWmdIpPBG8ngsRE-SsuoQ-BLy6__j978X3Kvj5g9_UUnOmHAgtTsNiDwrsQvFR3SSaYDz1ymw0-9AgfeyTJXhx-0J3otinoX59cDXk</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2189139146</pqid></control><display><type>article</type><title>Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>MEDLINE</source><source>Directory of Open Access Journals(OpenAccess)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Min, Kyoung Lok ; Koo, Heejo ; Choi, Jun Jeong ; Kim, Dae Jung ; Chang, Min Jung ; Han, Euna</creator><contributor>Bianchi, Cesario</contributor><creatorcontrib>Min, Kyoung Lok ; Koo, Heejo ; Choi, Jun Jeong ; Kim, Dae Jung ; Chang, Min Jung ; Han, Euna ; Bianchi, Cesario</creatorcontrib><description>Type 2 diabetes mellitus (T2DM) is a chronic disease that requires long-term therapy and regular check-ups to prevent complications. In this study, insurance claim data from the National Health Insurance Service (NHIS) of Korea were used to investigate insulin use in T2DM patients according to the economic status of patients and their access to primary physicians, operationally defined as the frequently used medical care providers at the time of T2DM diagnosis. A total of 91,810 participants were included from the NHIS claims database for the period between 2002 and 2013. The utilization pattern of insulin was set as the dependent variable and classified as one of the following: non-use of antidiabetic drugs, use of oral antidiabetic drugs only, or use of insulin with or without oral antidiabetic drugs. The main independent variables of interest were level of income and access to a frequently-visited physician. Multivariate Cox proportional hazards analysis was performed. Insulin was used by 9,281 patients during the study period, while use was 2.874 times more frequent in the Medical-aid group than in the highest premium group [hazard ratio (HR): 2.874, 95% confidence interval (CI): 2.588-3.192]. Insulin was also used ~50% more often in the patients managed by a frequently-visited physician than in those managed by other healthcare professionals (HR: 1.549, 95% CI: 1.434-1.624). The lag time to starting insulin was shorter when the patients had a low income and no frequently-visited physicians. Patients with a low level of income were more likely to use insulin and to have a shorter lag time from diagnosis to starting insulin. The likelihood of insulin being used was higher when the patients had a frequently-visited physician, particularly if they also had a low level of income. Therefore, the economic statuses of patients should be considered to ensure effective management of T2DM. Utilizing frequently-visited physicians might improve the management of T2DM, particularly for patients with a low income.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0210159</identifier><identifier>PMID: 30840630</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Analysis ; Antidiabetics ; Biology and Life Sciences ; Care and treatment ; Chronic diseases ; Chronic illnesses ; Complications ; Confidence intervals ; Dependent variables ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - economics ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes therapy ; Diabetic neuropathy ; Diabetics ; Diagnosis ; Drugs ; Female ; Glucose ; Hazards ; Health aspects ; Health care ; Health Care Costs ; Health care industry ; Health care policy ; Health insurance ; Hemoglobin ; Hospitals ; Humans ; Hypoglycemic agents ; Hypoglycemic Agents - economics ; Hypoglycemic Agents - therapeutic use ; Income ; Independent variables ; Insulin ; Insulin - economics ; Insulin - therapeutic use ; Insurance ; Lag time ; Low income groups ; Low level ; Male ; Managed Care Programs - statistics & numerical data ; Medical personnel ; Medical research ; Medicine ; Medicine and Health Sciences ; Metabolism ; Middle Aged ; Mortality ; National health insurance ; National Health Programs - statistics & numerical data ; Patients ; People and Places ; Pharmaceutical sciences ; Pharmacy ; Physicians ; Planning ; Primary care ; Republic of Korea - epidemiology ; Retrospective Studies ; Risk factors ; Social Sciences ; Studies ; Treatment outcome ; Type 2 diabetes ; Young Adult</subject><ispartof>PloS one, 2019-03, Vol.14 (3), p.e0210159</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Min et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Min et al 2019 Min et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-c542bd209aba0c08a052a119c65ef72a710a38c84614cfacf692d5b1ff0eaaa53</citedby><cites>FETCH-LOGICAL-c692t-c542bd209aba0c08a052a119c65ef72a710a38c84614cfacf692d5b1ff0eaaa53</cites><orcidid>0000-0003-2656-7059</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402628/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402628/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30840630$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Bianchi, Cesario</contributor><creatorcontrib>Min, Kyoung Lok</creatorcontrib><creatorcontrib>Koo, Heejo</creatorcontrib><creatorcontrib>Choi, Jun Jeong</creatorcontrib><creatorcontrib>Kim, Dae Jung</creatorcontrib><creatorcontrib>Chang, Min Jung</creatorcontrib><creatorcontrib>Han, Euna</creatorcontrib><title>Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Type 2 diabetes mellitus (T2DM) is a chronic disease that requires long-term therapy and regular check-ups to prevent complications. In this study, insurance claim data from the National Health Insurance Service (NHIS) of Korea were used to investigate insulin use in T2DM patients according to the economic status of patients and their access to primary physicians, operationally defined as the frequently used medical care providers at the time of T2DM diagnosis. A total of 91,810 participants were included from the NHIS claims database for the period between 2002 and 2013. The utilization pattern of insulin was set as the dependent variable and classified as one of the following: non-use of antidiabetic drugs, use of oral antidiabetic drugs only, or use of insulin with or without oral antidiabetic drugs. The main independent variables of interest were level of income and access to a frequently-visited physician. Multivariate Cox proportional hazards analysis was performed. Insulin was used by 9,281 patients during the study period, while use was 2.874 times more frequent in the Medical-aid group than in the highest premium group [hazard ratio (HR): 2.874, 95% confidence interval (CI): 2.588-3.192]. Insulin was also used ~50% more often in the patients managed by a frequently-visited physician than in those managed by other healthcare professionals (HR: 1.549, 95% CI: 1.434-1.624). The lag time to starting insulin was shorter when the patients had a low income and no frequently-visited physicians. Patients with a low level of income were more likely to use insulin and to have a shorter lag time from diagnosis to starting insulin. The likelihood of insulin being used was higher when the patients had a frequently-visited physician, particularly if they also had a low level of income. Therefore, the economic statuses of patients should be considered to ensure effective management of T2DM. Utilizing frequently-visited physicians might improve the management of T2DM, particularly for patients with a low income.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Antidiabetics</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Chronic diseases</subject><subject>Chronic illnesses</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Dependent variables</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - economics</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes therapy</subject><subject>Diabetic neuropathy</subject><subject>Diabetics</subject><subject>Diagnosis</subject><subject>Drugs</subject><subject>Female</subject><subject>Glucose</subject><subject>Hazards</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health Care Costs</subject><subject>Health care industry</subject><subject>Health care policy</subject><subject>Health insurance</subject><subject>Hemoglobin</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypoglycemic agents</subject><subject>Hypoglycemic Agents - economics</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Income</subject><subject>Independent variables</subject><subject>Insulin</subject><subject>Insulin - economics</subject><subject>Insulin - therapeutic use</subject><subject>Insurance</subject><subject>Lag time</subject><subject>Low income groups</subject><subject>Low level</subject><subject>Male</subject><subject>Managed Care Programs - statistics & numerical data</subject><subject>Medical personnel</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>National health insurance</subject><subject>National Health Programs - statistics & numerical data</subject><subject>Patients</subject><subject>People and Places</subject><subject>Pharmaceutical sciences</subject><subject>Pharmacy</subject><subject>Physicians</subject><subject>Planning</subject><subject>Primary care</subject><subject>Republic of Korea - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Social Sciences</subject><subject>Studies</subject><subject>Treatment outcome</subject><subject>Type 2 diabetes</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11vFCEUhidGY2v1HxglMTF6sSsMM8zMjUnT-LGxSRNrvSVnGNhlw8IWGLX652V2p82O6YXhAnJ43hc4nJNlzwmeE1qRd2vXewtmvnVWznFOMCmbB9kxaWg-YzmmDw_WR9mTENYYl7Rm7HF2RHFdYEbxcfbnKmqjf0PUzqItxCi9DcgppG3ojbZIOT_EtbQxoJ86rlC82UqUo05DK6MMSHm3QXbnAAatJJgEDXIPVkgkDOhNQB1ESFF06fq0_cV5CU-zRwpMkM_G-SS7-vjh29nn2fnFp8XZ6flMsCaPM1EWedvluIEWsMA14DIHQhrBSqmqHCqCgdaiLhgphAKhkqorW6IUlgBQ0pPs5d53a1zgY94Cz0ndENqQgiVisSc6B2u-9XoD_oY70HwXcH7JwUctjOSqqzvWESYrXBY4p1CVZVW2smCK4rbpktf78bS-3chOpMR5MBPT6Y7VK750PzhLdiyvk8Gb0cC7616GyDc6CGkMWOn63b3rpmpYVSX01T_o_a8bqSWkB2irXDpXDKb8tEwuuMGkSNT8HiqNTm60SEWmdIpPBG8ngsRE-SsuoQ-BLy6__j978X3Kvj5g9_UUnOmHAgtTsNiDwrsQvFR3SSaYDz1ymw0-9AgfeyTJXhx-0J3otinoX59cDXk</recordid><startdate>20190306</startdate><enddate>20190306</enddate><creator>Min, Kyoung Lok</creator><creator>Koo, Heejo</creator><creator>Choi, Jun Jeong</creator><creator>Kim, Dae Jung</creator><creator>Chang, Min Jung</creator><creator>Han, Euna</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-2656-7059</orcidid></search><sort><creationdate>20190306</creationdate><title>Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea</title><author>Min, Kyoung Lok ; Koo, Heejo ; Choi, Jun Jeong ; Kim, Dae Jung ; Chang, Min Jung ; Han, Euna</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-c542bd209aba0c08a052a119c65ef72a710a38c84614cfacf692d5b1ff0eaaa53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Antidiabetics</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Chronic diseases</topic><topic>Chronic illnesses</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Dependent variables</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - economics</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes therapy</topic><topic>Diabetic neuropathy</topic><topic>Diabetics</topic><topic>Diagnosis</topic><topic>Drugs</topic><topic>Female</topic><topic>Glucose</topic><topic>Hazards</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Health Care Costs</topic><topic>Health care industry</topic><topic>Health care policy</topic><topic>Health insurance</topic><topic>Hemoglobin</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypoglycemic agents</topic><topic>Hypoglycemic Agents - economics</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Income</topic><topic>Independent variables</topic><topic>Insulin</topic><topic>Insulin - economics</topic><topic>Insulin - therapeutic use</topic><topic>Insurance</topic><topic>Lag time</topic><topic>Low income groups</topic><topic>Low level</topic><topic>Male</topic><topic>Managed Care Programs - statistics & numerical data</topic><topic>Medical personnel</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>National health insurance</topic><topic>National Health Programs - statistics & numerical data</topic><topic>Patients</topic><topic>People and Places</topic><topic>Pharmaceutical sciences</topic><topic>Pharmacy</topic><topic>Physicians</topic><topic>Planning</topic><topic>Primary care</topic><topic>Republic of Korea - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Social Sciences</topic><topic>Studies</topic><topic>Treatment outcome</topic><topic>Type 2 diabetes</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Min, Kyoung Lok</creatorcontrib><creatorcontrib>Koo, Heejo</creatorcontrib><creatorcontrib>Choi, Jun Jeong</creatorcontrib><creatorcontrib>Kim, Dae Jung</creatorcontrib><creatorcontrib>Chang, Min Jung</creatorcontrib><creatorcontrib>Han, Euna</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (ProQuest Medical & Health Databases)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>https://resources.nclive.org/materials</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agriculture Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest Biological Science Journals</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials science collection</collection><collection>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals(OpenAccess)</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Min, Kyoung Lok</au><au>Koo, Heejo</au><au>Choi, Jun Jeong</au><au>Kim, Dae Jung</au><au>Chang, Min Jung</au><au>Han, Euna</au><au>Bianchi, Cesario</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-03-06</date><risdate>2019</risdate><volume>14</volume><issue>3</issue><spage>e0210159</spage><pages>e0210159-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Type 2 diabetes mellitus (T2DM) is a chronic disease that requires long-term therapy and regular check-ups to prevent complications. In this study, insurance claim data from the National Health Insurance Service (NHIS) of Korea were used to investigate insulin use in T2DM patients according to the economic status of patients and their access to primary physicians, operationally defined as the frequently used medical care providers at the time of T2DM diagnosis. A total of 91,810 participants were included from the NHIS claims database for the period between 2002 and 2013. The utilization pattern of insulin was set as the dependent variable and classified as one of the following: non-use of antidiabetic drugs, use of oral antidiabetic drugs only, or use of insulin with or without oral antidiabetic drugs. The main independent variables of interest were level of income and access to a frequently-visited physician. Multivariate Cox proportional hazards analysis was performed. Insulin was used by 9,281 patients during the study period, while use was 2.874 times more frequent in the Medical-aid group than in the highest premium group [hazard ratio (HR): 2.874, 95% confidence interval (CI): 2.588-3.192]. Insulin was also used ~50% more often in the patients managed by a frequently-visited physician than in those managed by other healthcare professionals (HR: 1.549, 95% CI: 1.434-1.624). The lag time to starting insulin was shorter when the patients had a low income and no frequently-visited physicians. Patients with a low level of income were more likely to use insulin and to have a shorter lag time from diagnosis to starting insulin. The likelihood of insulin being used was higher when the patients had a frequently-visited physician, particularly if they also had a low level of income. Therefore, the economic statuses of patients should be considered to ensure effective management of T2DM. Utilizing frequently-visited physicians might improve the management of T2DM, particularly for patients with a low income.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30840630</pmid><doi>10.1371/journal.pone.0210159</doi><tpages>e0210159</tpages><orcidid>https://orcid.org/0000-0003-2656-7059</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-03, Vol.14 (3), p.e0210159 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2189139146 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; Directory of Open Access Journals(OpenAccess); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Aged Analysis Antidiabetics Biology and Life Sciences Care and treatment Chronic diseases Chronic illnesses Complications Confidence intervals Dependent variables Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - economics Diabetes Mellitus, Type 2 - epidemiology Diabetes therapy Diabetic neuropathy Diabetics Diagnosis Drugs Female Glucose Hazards Health aspects Health care Health Care Costs Health care industry Health care policy Health insurance Hemoglobin Hospitals Humans Hypoglycemic agents Hypoglycemic Agents - economics Hypoglycemic Agents - therapeutic use Income Independent variables Insulin Insulin - economics Insulin - therapeutic use Insurance Lag time Low income groups Low level Male Managed Care Programs - statistics & numerical data Medical personnel Medical research Medicine Medicine and Health Sciences Metabolism Middle Aged Mortality National health insurance National Health Programs - statistics & numerical data Patients People and Places Pharmaceutical sciences Pharmacy Physicians Planning Primary care Republic of Korea - epidemiology Retrospective Studies Risk factors Social Sciences Studies Treatment outcome Type 2 diabetes Young Adult |
| title | Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T06%3A10%3A32IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Utilization%20patterns%20of%20insulin%20for%20patients%20with%20type%202%20diabetes%20from%20national%20health%20insurance%20claims%20data%20in%20South%20Korea&rft.jtitle=PloS%20one&rft.au=Min,%20Kyoung%20Lok&rft.date=2019-03-06&rft.volume=14&rft.issue=3&rft.spage=e0210159&rft.pages=e0210159-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0210159&rft_dat=%3Cgale_plos_%3EA577309014%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2189139146&rft_id=info:pmid/30840630&rft_galeid=A577309014&rft_doaj_id=oai_doaj_org_article_fd8d6d16e7054023a75575be46f30b9d&rfr_iscdi=true |