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Original Article
- Associations between usual source of care characteristics and health outcomes in diabetes mellitus: a focus on medication adherence and healthy behaviors in Korea
- Seung Eun Lee, Chul-Woung Kim, Ji Eun Bae, Jee Hyun Choi
- Epidemiol Health. 2025;47:e2025063. Published online December 2, 2025
- DOI: https://doi.org/10.4178/epih.e2025063
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- 1 Web of Science
- 2 Crossref
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Abstract
Summary
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AbstractOBJECTIVES
This study investigated the associations between usual source of care (USC) characteristics, which incorporate primary care functions, and medication adherence and healthy behaviors in Korean adults with diabetes.METHODSWe used data from 1,543 adults with diabetes in the 2020 Korea Health Panel Survey. USC was categorized into 5 types based on whether a regular doctor was identified and whether that provider fulfilled comprehensiveness and coordination functions. Multivariable logistic regression was used to assess associations with medication adherence and healthy behaviors.RESULTSA significant difference in medication adherence was observed by USC type, although no significant associations emerged for healthy behaviors (smoking, drinking, exercise). Compared to the group without a USC, patients whose regular doctor fulfilled either function were 2.38 times more likely to adhere (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.70 to 3.32), and those whose doctor fulfilled both functions were 1.84 times more likely to adhere (OR, 1.84; 95% CI, 1.31 to 2.59). This association was particularly strong for adherence to medication dosage, frequency, and timing.CONCLUSIONSThe findings underscore that the functional quality of the USC, particularly the fulfillment of comprehensiveness and coordination, is crucial in improving medication adherence. Simply having a USC is insufficient. The lack of association with healthy behaviors suggests that physicians may focus more on pharmacological control, highlighting the need for multifaceted interventions. -
SummaryKorean summary
본 연구는 단순히 주치의가 있는 것만으로는 당뇨병 환자의 복약 순응에 불충분하며, 일차 의료 기능을 충실히 수행하는 상용치료원만이 복약 순응과 유의한 관련이 있음을 입증했습니다. 하지만 상용치료원이 건강 행동 개선과는 관련이 없음을 확인하여, 의료진이 생활 습관 개선에는 영향을 주지 못하고 있음을 시사했습니다. 이러한 결과는 만성질환 관리를 개선하기 위해 상용치료원의 일차 의료 기능을 강화해야 한다는 정책적 근거를 제공합니다.Key Message
This study shows that simply having a usual source of care (USC) is insufficient; only USCs that fully perform primary care functions are significantly associated with better medication adherence in diabetic patients. However, USC was not linked to improved health behaviors, suggesting providers fail to influence lifestyle changes. The findings provide policy evidence to reinforce the primary care functions of USCs to enhance chronic disease management. -
Citations
Citations to this article as recorded by
- Association Between Usual Source of Care Types and Health Behaviors: Smoking Cessation, Alcohol Abstinence, and Physical Activity
Jeong-Hee Kang, Chul-Woung Kim
Research in Community and Public Health Nursing.2026; 37: 101. CrossRef - Income level and the risk of incident dementia among adults aged ≥50 with newly diagnosed type 2 diabetes: a population-based cohort study using the NHIS-Senior database in South Korea
Su-Min Park, Ah Jung Ko, Jae Hyeok Lim, Eun-Cheol Park
BMJ Open.2026; 16(7): e112641. CrossRef
- Association Between Usual Source of Care Types and Health Behaviors: Smoking Cessation, Alcohol Abstinence, and Physical Activity
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