{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:28:36Z","timestamp":1787963316556,"version":"build-2784847793"},"reference-count":23,"publisher":"Korean Society of Epidemiology","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["e-epih.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol Health"],"abstract":"<jats:p>OBJECTIVES: This study evaluated the long-term effectiveness of Korea\u2019s Primary Care Chronic Disease Management Program (CDMP) on major clinical outcomes among patients with type 2 diabetes mellitus (T2DM).METHODS: Patients aged \u226518 years who received outpatient care for T2DM in 2019 were identified using Korea\u2019s National Health Insurance Claims Database. Patients with a prior history of inpatient or outpatient care for ischemic heart disease (IHD) or stroke, or a history of hospitalization for diabetes before the index date were excluded. The final cohort included 1,817,682 patients, who were followed from the index date to December 31, 2023, for preventable diabetes-related hospitalization and incident IHD and stroke. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).RESULTS: The study included 49,449 CDMP participants and 1,768,233 non-participants. The mean ages of the CDMP and non-CDMP groups were 62.2 years and 61.5 years, respectively. Compared with non-participants, CDMP participants had significantly lower risks of any adverse health outcome (HR, 0.87; 95% CI, 0.85 to 0.89), IHD (HR, 0.94; 95% CI, 0.91 to 0.97), stroke (HR, 0.85; 95% CI, 0.82 to 0.89), and diabetes-related hospitalization (HR, 0.73; 95% CI, 0.70 to 0.76).CONCLUSIONS: Participation in the CDMP was associated with improved long-term health outcomes among patients with T2DM. These findings support the importance of continuous, structured, primary care\u2013based chronic disease management and provide empirical evidence for expanding and institutionalizing the CDMP within Korea\u2019s National Health Insurance system.<\/jats:p>","DOI":"10.4178\/epih.e2026023","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:39:44Z","timestamp":1780033184000},"page":"e2026023","update-policy":"https:\/\/doi.org\/10.4178\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term effectiveness of a primary care chronic disease management program in Korea"],"prefix":"10.4178","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1798-4496","authenticated-orcid":true,"given":"Seo-Hyun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Health Administration, Kongju National University College of Nursing and Health, Gongju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-3166","authenticated-orcid":true,"given":"Kyoung-Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Health Administration, Kongju National University College of Nursing and Health, Gongju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2679","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12712"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2024.39.e67"},{"key":"ref4","volume-title":"Chronic diseases: current status and issues"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10450-3"},{"key":"ref6","volume-title":"Diabetes fact sheet in Korea 2022"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-S003"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-S005"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2018.0189"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2021.88509"},{"key":"ref11","volume-title":"Quality and outcomes framework guidance for 2025\/26 [cited 2025 Nov 2]"},{"key":"ref12","volume-title":"Use of chronic disease management and allied health Medicare services","year":"2022"},{"key":"ref13","volume-title":"Guidelines for the 2019 pilot program for primary care chronic disease managemen","year":"2019"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.23060\/kihasa.a.2023.47"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.14367\/kjhep.2020.37.5.51"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3904\/kjm.2021.96.1.7"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3961\/jpmph.23.250"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2024.0275"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0299035"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-032790"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18073396"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2024.39.e158"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-025-13227-1"}],"container-title":["Epidemiology and Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.e-epih.org\/upload\/pdf\/epih-48-e2026023.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.e-epih.org\/journal\/view.php?doi=10.4178\/epih.e2026023","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.e-epih.org\/upload\/pdf\/epih-48-e2026023.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:27:51Z","timestamp":1785479271000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.e-epih.org\/journal\/view.php?doi=10.4178\/epih.e2026023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":23,"URL":"https:\/\/doi.org\/10.4178\/epih.e2026023","relation":{},"ISSN":["2092-7193"],"issn-type":[{"value":"2092-7193","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]},"assertion":[{"value":"2026-02-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-27","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}}]}}