Analysis of the Impact of the TelE-Medicine Program for Medically Underserved Area on Hospitalization Rates Among Diabetic Patients in Medically Underserved Areas
Author(s)
Won Taeg Oh, BS1, Jaehee Jung, RPh2, Hye-Young Kang, PhD2.
1Graduate Program of Industrial Pharmaceutical Science, Yonsei University, Incheon, Korea, Republic of, 2College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Korea, Republic of.
1Graduate Program of Industrial Pharmaceutical Science, Yonsei University, Incheon, Korea, Republic of, 2College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Korea, Republic of.
Presentation Documents
OBJECTIVES: We evaluated the impact of the government’s telemedicine program (TP), introduced in 2017, on diabetes-related hospitalization (DRH) rates among diabetic patients in medically underserved areas (MUAs) by analyzing trends across 45 MUAs.
METHODS: Using the National Health Insurance Service (NHIS) Sample Cohort—comprising 2.2% of Korea’s 2006 population stratified by age, sex, insurance type, and income—we constructed annual cohorts from 2014 to 2019 to identify diabetic patients aged ≥50. We calculated the annual DRH rate in MUAs and non-medically underserved areas (NMUAs), defined as the proportion of diabetic individuals experiencing a DRH each year. Changes in DRH rates over time were compared between MUAs and NMUAs. Additionally, MUAs were categorized into high, medium, and low TP utilization groups based on per-capita usage rates reported in 2018, and DRH trends were compared across these groups
RESULTS: From 2014 to 2019, DRH rates in MUAs remained consistently higher than in NMUAs, although both showed a declining trend. In MUAs, the DRH rate decreased modestly from 11.36% in 2014 to 10.61% in 2016 (a 6.6% reduction). Following the TP implementation, the rate declined substantially to 6.55% in 2019 (a 38.3% reduction from 2016). In NMUAs, DRH fell from 9.44% in 2014 to 9.17% in 2016, and further to 7.78% in 2019 (a 15.1% post-2016 reduction). Among MUAs, the high-utilization group saw the greatest DRH reduction (37.2%) from 2016 to 2019, compared to the medium (8.7%) and low-utilization groups (27.8%), suggesting a dose-response relationship between program usage and outcomes.
CONCLUSIONS: The TP led to greater reductions in diabetes-related hospitalizations in MUAs than in non-MUAs. Higher TP utilization within MUAs was linked to more pronounced improvements, supporting the program’s effectiveness and the need for its continued expansion in underserved regions.
METHODS: Using the National Health Insurance Service (NHIS) Sample Cohort—comprising 2.2% of Korea’s 2006 population stratified by age, sex, insurance type, and income—we constructed annual cohorts from 2014 to 2019 to identify diabetic patients aged ≥50. We calculated the annual DRH rate in MUAs and non-medically underserved areas (NMUAs), defined as the proportion of diabetic individuals experiencing a DRH each year. Changes in DRH rates over time were compared between MUAs and NMUAs. Additionally, MUAs were categorized into high, medium, and low TP utilization groups based on per-capita usage rates reported in 2018, and DRH trends were compared across these groups
RESULTS: From 2014 to 2019, DRH rates in MUAs remained consistently higher than in NMUAs, although both showed a declining trend. In MUAs, the DRH rate decreased modestly from 11.36% in 2014 to 10.61% in 2016 (a 6.6% reduction). Following the TP implementation, the rate declined substantially to 6.55% in 2019 (a 38.3% reduction from 2016). In NMUAs, DRH fell from 9.44% in 2014 to 9.17% in 2016, and further to 7.78% in 2019 (a 15.1% post-2016 reduction). Among MUAs, the high-utilization group saw the greatest DRH reduction (37.2%) from 2016 to 2019, compared to the medium (8.7%) and low-utilization groups (27.8%), suggesting a dose-response relationship between program usage and outcomes.
CONCLUSIONS: The TP led to greater reductions in diabetes-related hospitalizations in MUAs than in non-MUAs. Higher TP utilization within MUAs was linked to more pronounced improvements, supporting the program’s effectiveness and the need for its continued expansion in underserved regions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR25
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Health Disparities & Equity
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas