Treatment Gap in the National Health-screening Program in Korea: Claim-based Follow-up of Statin Use for Sustained Hypercholesterolemia.
10.3346/jkms.2015.30.9.1266
- Author:
Eunmi AHN
1
;
Dong Wook SHIN
;
Hyung kook YANG
;
Jae Moon YUN
;
So Hyun CHUN
;
Beomseok SUH
;
Hyejin LEE
;
Ki Young SON
;
BeLong CHO
Author Information
1. Cancer Policy Branch, National Cancer Control Research Institute, National Cancer Center, Goyang, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Hypercholesterolemia;
Cholesterol;
Cardiovascular Diseases;
Prevention;
Statins
- MeSH:
Adult;
Chronic Disease;
Drug Prescriptions/statistics & numerical data;
Female;
Health Services Accessibility/statistics & numerical data;
Healthcare Disparities/*statistics & numerical data;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use;
Hypercholesterolemia/*diagnosis/epidemiology/*prevention & control;
Insurance Claim Reporting/statistics & numerical data;
Male;
Mass Screening/*utilization;
Middle Aged;
National Health Programs/*utilization;
Prevalence;
Republic of Korea/epidemiology;
Risk Assessment;
Treatment Outcome;
Young Adult
- From:Journal of Korean Medical Science
2015;30(9):1266-1272
- CountryRepublic of Korea
- Language:English
-
Abstract:
Participation in a screening program by itself may not improve clinical outcomes. Treatment gaps in the program may limit its full benefit. We evaluated statin prescription rates for subjects with sustained hypercholesterolemia to assess the treatment gaps in the National Health Screening Program (NHSP) in Korea. A retrospective, random cohort was established among National Health Insurance Corporation (NHIC) members. Finally, we examined 465,499 individuals who attended the NHSP from 2003 to 2010 without any history of dyslipidemia, statin prescription, or hospitalization for cardiovascular events until the end of 2002. The subsequent statin prescription rates were identified from the NHIC medical service claim database from 2003 to 2011. Descriptive data and odds ratio from multivariate logistic analyses on statin prescription rates and the corresponding correlations were evaluated. The NHSP detected 114,085 (24.5%) cases of newly diagnosed hypercholesterolemia. However, only 8.6% of these received statin prescription within 6 months of diagnosis. For cases of sustained hypercholesterolemia determined in the next screening visit by the NHSP, the statin prescription rate increased, but only to 12.2%. Statin prescriptions were more common among females, older individuals, and hypertension or diabetes patients. Furthermore, the statin prescription rates had increased over the study period. The NHSP exhibited low statin prescription rate which has been improving. For the NHSP to be effective, it would be worthwhile to decrease the gap between the diagnosis of hypercholesterolemia and the following treatment.
