Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetes mellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registered group from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number of clinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health Insurance Corporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and defined above 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logistic regression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regression model, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higher Odds ratio in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertension or type 2 diabetes mellitus.

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Objectives: This study is based on Public Care Service for Chronic Diseases in Incheon Metropolitan City featuring Health-Point Service. It is objective to evaluate whether the service could improve self-management ability of hypertension and diabetes patients. Methods: The knowledge about diabetes and hypertension, which can be improved by educational intervention, is considered as one of the most important factor for self-management ability. While the education service have been conducted, 194 patients who have been diagnosed as hypertension and diabetes within 3 months were included. They completed questionnaires two times within 4 months period, which give information about the knowledge, service registration and education experiences. For further inspection, 396 patients who had been diagnosed formerly were studied by cross-sectional analysis. Results: Regardless of service registration or educational intervention, there wasn't statistically meaningful difference between the initial and the follow-up assessments on the knowledge. However, when investigating formerly diagnosed patients, educated patients had better knowledge on hypertension compared with non-educated patients and registered patients, educated patients had the better knowledge on diabetes compared with non-registered patients, non-educated patients. Additionally, analyzing each questions, educated patients got higher grades in questions about definition of hypertension, diabetes managements which they can practice in daily lives. Conclusions: It is probable that long-term service registration and education experiences could improve the knowledge and self-management ability.

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study aims to examine the effect of socioeconomic status (hereafter, SES) on healthcare utilization of the patients with rare and incurable diseases. Information of 2,973 patients who were self-employed insured and utilized healthcare service in 2007 was drawn from the National Health Insurance (hereafter, NHI) claim data. SES was set as four groups based on the monthly contribution. Outcome variable was the expense for outpatient and in-hospital services, which was log-transformed and square-rooted in oder to obtain normal distribution. Covariates included age, gender, residence and diagnosis. To examine