IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0210159.html
   My bibliography  Save this article

Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea

Author

Listed:
  • Kyoung Lok Min
  • Heejo Koo
  • Jun Jeong Choi
  • Dae Jung Kim
  • Min Jung Chang
  • Euna Han

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.

Suggested Citation

  • Kyoung Lok Min & Heejo Koo & Jun Jeong Choi & Dae Jung Kim & Min Jung Chang & Euna Han, 2019. "Utilization patterns of insulin for patients with type 2 diabetes from national health insurance claims data in South Korea," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-14, March.
  • Handle: RePEc:plo:pone00:0210159
    DOI: 10.1371/journal.pone.0210159
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210159
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0210159&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0210159?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Lasser, K.E. & Himmelstein, D.U. & Woolhandler, S., 2006. "Access to care, health status, and health disparities in the United States and Canada: Results of a Cross-National Population Based Survey," American Journal of Public Health, American Public Health Association, vol. 96(7), pages 1300-1307.
    2. 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.
    3. Martin Wong & Michael Leung & Caroline Tsang & S. Lo & Sian Griffiths, 2013. "The rising tide of diabetes mellitus in a Chinese population: a population-based household survey on 121,895 persons," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(2), pages 269-276, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kim, Woohyeon & Han, Euna, 2022. "Antibiotic prescription for acute upper respiratory tract infections: Understanding patient and physician contributions via patients’ migration," Social Science & Medicine, Elsevier, vol. 314(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Marco Marozzi & Mario Bolzan, 2018. "An Index of Household Accessibility to Basic Services: A Study of Italian Regions," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 136(3), pages 1237-1250, April.
    2. Duncan Gillespie & Meredith Trotter & Shripad Tuljapurkar, 2014. "Divergence in Age Patterns of Mortality Change Drives International Divergence in Lifespan Inequality," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 1003-1017, June.
    3. Bukola Salami & Alleson Mason & Jordana Salma & Sophie Yohani & Maryam Amin & Philomena Okeke-Ihejirika & Tehseen Ladha, 2020. "Access to Healthcare for Immigrant Children in Canada," IJERPH, MDPI, vol. 17(9), pages 1-12, May.
    4. Laia Palència & Albert Espelt & Maica Rodríguez-Sanz & Katia B. Rocha & M. Isabel Pasarín & Carme Borrell, 2013. "Trends in social class inequalities in the use of health care services within the Spanish National Health System, 1993–2006," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 211-219, April.
    5. Susan Averett & Laura Argys & Julia Sorkin, 2013. "In sickness and in health: an examination of relationship status and health using data from the Canadian National Public Health Survey," Review of Economics of the Household, Springer, vol. 11(4), pages 599-633, December.
    6. Jung In Kim & Devini Manouri Senaratna & Jacobo Ruza & Calvin Kam & Sandy Ng, 2015. "Feasibility Study on an Evidence-Based Decision-Support System for Hospital Site Selection for an Aging Population," Sustainability, MDPI, vol. 7(3), pages 1-15, March.
    7. G. Trohel & V. Bertaud-Gounot & M. Soler & P. Chauvin & Olivier Grimaud, 2016. "Socio-Economic determinants of the need for dental care in adults," Post-Print hal-01372359, HAL.
    8. Hugh Armstrong & Wallace Clement & Zhiqiu Lin & Steven Prus, 2006. "Contrasting Inequalities: Comparing Correlates of Health in Canada and the United States," Social and Economic Dimensions of an Aging Population Research Papers 167, McMaster University.
    9. Siddiqi, Arjumand & Zuberi, Daniyal & Nguyen, Quynh C., 2009. "The role of health insurance in explaining immigrant versus non-immigrant disparities in access to health care: Comparing the United States to Canada," Social Science & Medicine, Elsevier, vol. 69(10), pages 1452-1459, November.
    10. Faten Tlili & Francine Tinsa & Afef Skhiri & Shahaduz Zaman & Peter Phillimore & Habiba Ben Romdhane, 2015. "Living with diabetes and hypertension in Tunisia: popular perspectives on biomedical treatment," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(1), pages 31-37, January.
    11. Sumedha Arya & Pamela Wilton & David Page & Laurence Boma-Fischer & Georgina Floros & Katie N Dainty & Rochelle Winikoff & Michelle Sholzberg, 2020. "Healthcare provider perspectives on inequities in access to care for patients with inherited bleeding disorders," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-10, February.
    12. Gilda Trohel & Valérie Bertaud-Gounot & Marion Soler & Pierre Chauvin & Olivier Grimaud, 2016. "Socio-Economic Determinants of the Need for Dental Care in Adults," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-11, July.
    13. Ybarra, Marci & Ha, Yoonsook & Chang, Jina, 2017. "Health insurance coverage and routine health care use among children by family immigration status," Children and Youth Services Review, Elsevier, vol. 79(C), pages 97-106.
    14. Tetsuji Yamada & Chia-Ching Chen & Chiyoe Murata & Hiroshi Hirai & Toshiyuki Ojima & Katsunori Kondo & Joseph R. Harris III, 2015. "Access Disparity and Health Inequality of the Elderly: Unmet Needs and Delayed Healthcare," IJERPH, MDPI, vol. 12(2), pages 1-28, February.
    15. Singhal, Sonica & Mamdani, Muhammad & Mitchell, Andrew & Tenenbaum, Howard & Lebovic, Gerald & Quiñonez, Carlos, 2016. "Dental treatment and employment outcomes among social assistance recipients in Ontario, Canada," Health Policy, Elsevier, vol. 120(10), pages 1202-1208.
    16. Mutsa Mutowo & Usha Gowda & John Mangwiro & Paula Lorgelly & Alice Owen & Andre Renzaho, 2015. "Prevalence of diabetes in Zimbabwe: a systematic review with meta-analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(1), pages 1-11, January.
    17. Samuel D. Towne Jr., 2017. "Socioeconomic, Geospatial, and Geopolitical Disparities in Access to Health Care in the US 2011–2015," IJERPH, MDPI, vol. 14(6), pages 1-15, May.
    18. Gitte Valentin & Claus Vinther Nielsen & Anne-Sofie Meldgaard Nielsen & Merete Tonnesen & Kristina Louise Bliksted & Katrine Tranberg Jensen & Karen Ingerslev & Thomas Maribo & Lisa Gregersen Oesterga, 2023. "Bridging Inequity Gaps in Healthcare Systems While Educating Future Healthcare Professionals—The Social Health Bridge-Building Programme," IJERPH, MDPI, vol. 20(19), pages 1-17, September.
    19. Asanin, Jennifer & Wilson, Kathi, 2008. ""I spent nine years looking for a doctor": Exploring access to health care among immigrants in Mississauga, Ontario, Canada," Social Science & Medicine, Elsevier, vol. 66(6), pages 1271-1283, March.
    20. Charles Gyan & Batholomew Chireh, 2024. "Factors Associated with the Sense of Community Belonging of Immigrants: Insight from the 2011–2018 Canadian Community Health Survey," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 19(5), pages 2685-2704, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0210159. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.