Regular Hospital Visits Cut Cardiovascular Risk by 34% for Chronic Disease Patients

Patients with chronic conditions such as hypertension and diabetes benefit more from consistent care at a single hospital than from switching between multiple healthcare providers, a new study has found.

A joint research team led by Professor Kang Hee-taek of Severance Hospital's Department of Family Medicine and Professor Shim Jae-yong of Gangnam Severance Hospital's Department of Family Medicine announced on May 13 that they reached these findings after tracking 14,246 hypertension patients and 9,382 diabetes patients aged 60 and older for an average of 16 years, using health screening cohort data from the National Health Insurance Service.

Hypertension and diabetes are the most common chronic diseases in South Korea and major risk factors for fatal cardiovascular and cerebrovascular diseases such as myocardial infarction and stroke. Both conditions require long-term consistent management, but in practice, care is often fragmented as patients visit multiple healthcare institutions. Suspicions have been raised that this pattern of healthcare utilization may explain why chronic disease control rates remain lower than expected despite South Korea's relatively high numbers of outpatient visits and hospitalization days compared to other countries.

The research team examined "continuity of care"—the degree to which patients consistently receive treatment from the same healthcare institution or medical staff—as an important indicator of chronic disease management and analyzed its correlation with actual health outcomes.

The analysis found that hypertension patients with high continuity of care had fewer hospitalizations than those with low continuity. Total medical expenses related to hypertension treatment, medical costs per hospital visit, and annual medical expenses all tended to be lower in the high-continuity group. The difference was particularly pronounced in cardiovascular disease risk. Hypertension patients with the highest continuity of care had approximately 34% lower cardiovascular disease risk in men and approximately 30% lower risk in women compared to those with the lowest continuity. Risks of ischemic cardiovascular diseases such as myocardial infarction and cerebrovascular diseases such as stroke also showed overall declining trends.

Similar results were observed in diabetes patients. Patients with higher continuity of care showed decreases in outpatient visits, hospitalizations, and annual medical expenses. Diabetes patients who continued receiving care at the same healthcare institution had the lowest total and annual medical expenses among the study subjects. Diabetes patients with the highest continuity of care had approximately 19% lower mortality risk in men and approximately 18% lower risk in women compared to those with the lowest continuity. Cardiovascular disease risk also decreased in both men and women. Analysis results adjusting for age, body mass index (BMI), blood pressure, blood sugar, cholesterol levels, lifestyle factors such as smoking and drinking, income level, and comorbidities showed the same trends.

The findings confirm that sustained treatment relationships with specific healthcare institutions are more important than the frequency of healthcare utilization for both patient health and medical cost reduction in chronic disease management. The research team assessed the study as significant for demonstrating that consistent chronic disease management centered on one healthcare institution can reduce hospitalizations and emergency room visits, lower medical expense burdens, and decrease cardiovascular and cerebrovascular disease risks as well as mortality risk. This suggests the growing importance of primary care's role in providing comprehensive and continuous management based on sustained relationships between patients and medical staff.

"For chronic diseases like hypertension and diabetes, long-term management is more important than short-term treatment," Professor Kang Hee-taek explained. "The more consistently patients receive care at the same healthcare institution, the more stable their disease management becomes and the lower their complication risks can be."

"This shows that policies strengthening primary care-centered continuous treatment systems for chronic disease management can help reduce not only patient health burdens but also overall healthcare costs for society," Professor Shim Jae-yong emphasized.

The study was published in the latest issue of "Nutrition, Metabolism & Cardiovascular Diseases," an international journal in the cardiovascular and metabolic disease field.