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Association between Continuity of Care and the Onset of Thyroid Disorder among Diabetes Patients in Korea

Author

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  • Sang Ah Lee

    (Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea
    Institute of Health Services Research, Yonsei University, Seoul 03722, Korea)

  • Sung-Youn Chun

    (Institute of Health Services Research, Yonsei University, Seoul 03722, Korea
    Department of community health science, University of Nevada Las Vegas, Las Vegas, NV 89154-9900, USA)

  • Woorim Kim

    (Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea
    Institute of Health Services Research, Yonsei University, Seoul 03722, Korea)

  • Yeong Jun Ju

    (Institute of Health Services Research, Yonsei University, Seoul 03722, Korea
    Department of Preventive Medicine and Public Health, Ajou University, School of Medicine, Suwon 16499, Korea)

  • Dong-Woo Choi

    (Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea
    Institute of Health Services Research, Yonsei University, Seoul 03722, Korea)

  • Eun-Cheol Park

    (Institute of Health Services Research, Yonsei University, Seoul 03722, Korea
    Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea)

Abstract

Objectives : As the relationship between diabetes mellitus and thyroid dysfunction is well known, it is important to investigate the factors influencing this association. Continuity of care is associated with better quality of care and outcomes, such as reduced complications, among diabetes patients. Therefore, the purpose of this study was to investigate the association between continuity of care and the onset of thyroid dysfunction among diabetes patients. Methods : We used Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013. Our final study population included 16,806 newly diagnosed diabetes patients who were older than 45 years of age. Continuity of care was measured using the Continuity of Care index. The dependent variable was the onset of thyroid disorder. Cox proportional hazard regression models were used for statistical analyses. Results : Diabetes patients with low continuity of care were at increased risk of the onset of thyroid disorder compared with those with high continuity of care (hazard ratio (HR): 1.28, 95% confidence interval (CI): 1.07–1.54). Subgroup analyses showed that this association was significant within patients with type 2 diabetes (HR: 1.24, 95% CI: 1.01–1.52) or whose main attending site was a local clinic (HR: 1.32, 95% CI: 1.07–1.64). Conclusions : Our results show that diabetes patients with low continuity of care are more likely to experience the onset of thyroid disorder. Therefore, improving continuity of care could be a reasonable method of preventing complications or comorbidities, including thyroid disorder, among diabetes patients.

Suggested Citation

  • Sang Ah Lee & Sung-Youn Chun & Woorim Kim & Yeong Jun Ju & Dong-Woo Choi & Eun-Cheol Park, 2019. "Association between Continuity of Care and the Onset of Thyroid Disorder among Diabetes Patients in Korea," IJERPH, MDPI, vol. 16(2), pages 1-9, January.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:2:p:233-:d:197945
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    References listed on IDEAS

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    1. Mainous III, A.G. & Koopman, R.J. & Gill, J.M. & Baker, R. & Pearson, W.S., 2004. "Relationship between Continuity of Care and Diabetes Control: Evidence from the Third National Health and Nutrition Examination Survey," American Journal of Public Health, American Public Health Association, vol. 94(1), pages 66-70.
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