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Original Article
Dementia and Neurocognitive Disorders 2023: 22: 2: 49-60

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Dementia Incidence Rate Before and After Implementing the National Responsibility Policy for Dementia Care in Patients With Vascular Risk Factors in Korea
Gihwan Byeon , 1,* Sung Ok Kwon , 2,* JinHyeong Jhoo , 1,3 Jae-Won Jang , 4 Yeshin Kim 4
1 Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea 2 Interdisciplinary Graduate Program in Medical Bigdata Convergence, Kangwon National University, Chuncheon, Korea 3 Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea 4 Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Korea
Dementia Incidence Rate Before and After Implementing the National Responsibility Policy for Dementia Care in Patients With Vascular Risk Factors in Korea
Gihwan Byeon , 1,* Sung Ok Kwon , 2,* JinHyeong Jhoo , 1,3 Jae-Won Jang , 4 Yeshin Kim 4
1 Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea 2 Interdisciplinary Graduate Program in Medical Bigdata Convergence, Kangwon National University, Chuncheon, Korea 3 Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea 4 Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Korea
Background and Purpose: The National Responsibility Policy for Dementia Care was
implemented in September 2017 in Korea. This study aimed to compare dementia incidence
in Seoul and Gangwon-do before and after the implementation of this policy.
Methods: We extracted insurance claim data from the Korean Health Insurance Review
and Assessment Service for people diagnosed with diabetes, hypertension, or dyslipidemia
for the first time in Seoul and Gangwon-do, Korea. We defined two enrollment groups
based on the policy implementation date: 1) January 1, 2015 to December 31, 2016 (Index
1, pre-implementation), and 2) January 1, 2017 to December 31, 2018 (Index 2, postimplementation). Each group was followed up for 1 year from the time of enrollment. Then,
we calculated hazard ratios to compare the incidence of dementia between the two groups,
and between Seoul and Gangwon-do.
Results: In Seoul, the incidence of dementia was significantly lower in Index 2 than in
Index 1 (hazard ratio [HR], 0.926; 95% confidence interval [CI], 0.875–0.979). However,
the incidence rate did not differ between the 2 groups (HR, 1.113; 95% CI, 0.966–1.281)
in Gangwon-do. In Index 1, the incidence of dementia did not differ between Seoul and
Gangwon-do (HR, 1.043; 95% CI, 0.941–1.156), but in Index 2, was significantly higher in
Gangwon-do than in Seoul (HR, 1.240; 95% CI, 1.109–1.386).
Conclusions: After implementing the National Responsibility Policy for Dementia Care, the
dementia incidence rate decreased significantly in Seoul, consistent with other studies, but
not in Gangwon-do.
Key Words: Dementia; Health Policy; Healthcare Disparities
대한치매학회지 (Dementia and Neurocognitive Disorders)

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