Objectives: This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes. Methods: This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients’ first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%. Results: The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples. Conclusions This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.

Background: It is well known that the distribution of therapeutic materials is very complex. However, it is not easy to demonstrate the concrete problems caused by distribution channels empirically. The purpose of this study was to investigate the differences in the price of therapeutic materials according to the type of purchasing agency and the way in which medical institutions purchase therapeutic materials. Methods: This study compared the claimed prices and the maximum allowable prices for the items of therapeutic material used for general spinal surgery. Results: Ilsan Hospital, which purchased directly without a purchasing agent, had the lowest claimed prices, followed by a large professional purchasing agency, a foundation-related purchasing agency, and a general purchasing agency. In addition, the difference between the claimed prices and the maximum allowable prices according to the purchase type was larger in the expensive treatment materials, and in the case of the lower price treatment materials, it tended to converge to the maximum allowable prices. Conclusion National health insurance spending for therapeutic materials are to be affected by the distribution channels of them. We proposed several ideas to rationalize the expenditure such as classification of therapeutic materials on the basis of price or other criteria.

PURPOSE: To compare the level of accuracy of intraocular pressure (IOP) measurements of a rebound tonometer (RT) Icare(R), and non-contact tonometer (NCT), using Goldmann Applanation tonometer (GAT) as a reference to evaluate the influence of central corneal thickness (CCT) on IOP readings in the Korean population. METHODS: In a prospective study of 273 eyes, IOP was measured with RT, GAT, and NCT and compared to CCT measurements. Patients were assigned to one of 3 groups based on IOP measurements of GAT and 1 of 2 groups based on CCT. The comparison of the IOP values of RT, GAT, and NCT was performed between the IOP and CCT groups, and the differences among tonometers were evaluated. RESULTS: The RT showed statistically significant correlation with the GAT compared to the NCT. The CCT was related to RT measurements. The RT values compared to the GAT was underestimated in thin corneas and overestimated in thick corneas. CONCLUSIONS: There was a significant correlation between the RT and the GAT measurements compared with the NCT. However, RT is influenced by CCT and correlates less with GAT in low IOP ranges, suggesting that corneal thickness should be taken into consideration during such measurements.
Cornea ; Eye ; Humans ; Intraocular Pressure ; Peptides ; Prospective Studies ; Reading

PURPOSE: To compare retinal nerve fiber layer (RNFL) thickness measured by time domain (Stratus) and spectral domain (3D) optical coherence tomography (OCT). METHODS: Sixty-nine normal subjects and 92 glaucoma patients were included in the present study. Peripapillary RNFL thickness was measured with Stratus fast RNFL scan and 3D optic disc cube scan on the same day. The relationship between RNFL thickness measurements of the two OCTs were evaluated using a Pearson's correlation analysis. A Bland-Altman plot was used for the comparison of Stratus-OCT and 3D-OCT. RESULTS: In all subjects, average, superior, and inferior quadrant RNFL thicknesses measured by Stratus-OCT were thicker than those measured by 3D-OCT. In contrast, temporal and nasal quadrant RNFL thicknesses measured by 3D-OCT were thicker than those measured by Stratus-OCT. Although there were absolute value differences in RNFL thicknesses, high correlation was observed between Stratus-OCT and 3D-OCT (average: r = 0.897, temporal quadrant: r = 0.728, superior quadrant: r = 0.811, nasal quadrant: r = 0.678, and inferior quadrant: r = 0.905). Bland-Altman plots showed that Stratus-OCT values were greater than 3D-OCT values with relatively high RNFL thickness and the opposite with low RNFL thickness. CONCLUSIONS: For thicker RNFL, Stratus-OCT measurements tend to be greater than 3D-OCT, while for thinner RNFL, 3D-OCT measurements tend to be greater than Stratus-OCT. This difference must be taken into account if comparing measurements made with a Stratus-OCT to the measurements of a 3D-OCT.
Glaucoma ; Humans ; Nerve Fibers ; Retinaldehyde ; Tomography, Optical Coherence