Changes in Saturday outpatient volume and billings after introducing the Saturday incentive programme to clinics in South Korea: a longitudinal cohort study using claims data from 2012 to 2014.

OBJECTIVE: In October 2013, the South Korean government introduced an incentive programme to increase the availability of Saturday treatment at clinics, hoping to increase the role of primary care providers as gatekeepers to medical care. To the best of our knowledge, no one has yet investigated this programme's effect on overall outpatient care. Our study aims to analyse the change in Saturday outpatient volume and billings in clinics that adopted the Saturday incentive programme. SETTING: Our study used 3 types of data from the period October 2012 to March 2014: National Health Insurance Service (NHIS) claims data, hospital evaluation data and medical institution data. PARTICIPANTS: These data consisted of 66 825 881 outpatient cases from 2837 clinics. INTERVENTIONS: Introducing the Saturday incentive programme. OUTCOME MEASURE: We performed a multilevel analysis that adjusted for clinic-level and outpatient-level variables to examine the difference in the percentage of Saturday outpatient volume and billings after introducing the Saturday incentive programme. RESULTS: The percentages of Saturday outpatient volume and billings were higher after introducing the programme (outpatient volume: ß=2.065, p<0.001; outpatient billings: ß=3.518, p<0.001). In addition, outpatient volume and billings on Friday and Saturday increased after introducing the programme, while those on weekdays, excluding Friday, decreased. CONCLUSIONS: Our findings suggest that the Saturday incentive programme has affected clinic outpatient care and is a worthwhile health policy in terms of promoting primary care. Thus, it may improve healthcare accessibility and quality of care, and prevent inappropriate usage such as emergency room visits by providing patients with weekend clinic hours.

Consumption of pharmaceutical drugs in exception region of separation for drug prescribing and dispensing program in South Korea.

BACKGROUND: In the year 2000, the South Korean government introduced a program for separation of drug prescribing and dispensing. The goals of the program are to reduce misuse of drugs and to contain drug expenditures. The government also designated exception regions for the program to reduce the inconvenience for people who reside in areas with a shortage of health care resources. However, according to government reports, many adverse events related to drug misuse occurred in these exception regions after the program reforms were introduced. Therefore, it is worth investigating the factors that relate to drug consumption so that misuse in exception regions can be reduced. METHODS: Data from medical institutions, detailed drug supply data, and community health survey data were included in the analysis. Multilevel linear regression analysis using mixed models that included pharmacy-and regional-level variables were used to examine the associations regarding the percentages of drug types consumed (i.e., antipyretic, analgesic, anti-inflammatory drugs, psychotropic drugs, adrenal cortical hormones, and antibiotics). RESULTS: The data used in this analysis were from a total of 16,455 pharmacies. There were 1.9 % pharmacies from program exception regions and 98.1 % pharmacies from program application regions. Compared with the pharmacies in the program application regions, the exception region pharmacies had higher values for percent consumption of the antipyretic, analgesic, anti-inflammatory drugs category, and of the adrenal cortical hormones category (antipyretic, analgesic, anti-inflammatory drugs = ß: 3.19, Standard Error (SE): 0.82, t: 3.88, p-value < 0.05; adrenal cortical hormones = ß: 0.72, SE: 0.07, t: 9.92, p-value < 0.05). CONCLUSION: Our results suggested that pharmacies in exception regions supplied more antipyretic, analgesic, anti-inflammatory drugs, and more adrenal cortical hormones compared with the pharmacies where separation of drug prescribing and dispensing had been implemented. Health care professionals and health policy makers should consider management of health care expenditure by the category of drugs consumed, especially in program exception regions.

Combined effect of body mass index and body size perception on metabolic syndrome in South Korea: results of the fifth Korea National Health and Nutrition Examination Surveys (2010-2012).

BACKGROUND: Body mass index (BMI) has been used as an indirect predictor for the risk of metabolic syndrome. However, there are challenges in evaluating the risk of metabolic syndrome using BMI in certain parts of the world. Therefore, it is worth exploring additional factors that could supplement BMI to predict the risk of metabolic syndrome. In this study, we assessed the combined effect of BMI and perception for predicting metabolic syndrome. METHODS: We used the fifth Korea National Health and Nutrition Examination Surveys (KNHANES V, 2010-12, N = 16,537) in this study. Multivariable logistic regression analysis was performed to examine the association while controlling for potential confounding variables. We also performed an analysis for the combined effect of BMI and perception of body size, and subgroup analysis by age group or moderate physical activity. RESULTS: Data from 16,537 participants were analyzed in this study (males: 6,978, females: 9,559). Among them, metabolic syndrome was diagnosed in 1,252 (17.9%) males and 2,445 (25.6%) females, respectively. The combination of BMI and body size perception had a positive relation with the presence of metabolic syndrome. People who perceived themselves to be overweight for their body size had a higher risk for metabolic syndrome even if they have the same BMI. CONCLUSION: Our findings suggest that the combination of body size perception and BMI is useful in predicting the risk of metabolic syndrome. The use of complementary predictors could reduce the risk for inaccurate prediction of metabolic syndrome.