Background
Maintaining a usual source of care (USC), which is crucial for primary healthcare, encompasses initial contact, comprehensive services, coordinated care, and ongoing support. However, limited research exists on the relationship between USC and medication adherence in patients with hypertension. This study aimed to investigate the association between USC and medication adherence among patients with hypertension.
Methods
Data from the 2nd Korea Health Panel Survey 2020 were analyzed. The final sample consisted of 3,318 participants aged 19 years or older diagnosed with hypertension. USC was categorized into three groups: no USC, place only (without a regular doctor), and regular doctor. Medication adherence was assessed using detailed items (dose, frequency, time, no stop) and a 4-point Likert scale. A logistic regression analysis was conducted with control for relevant variables.
Results
Compared to the no USC group, the regular doctor group had significantly higher odds ratios (ORs) for overall perfect/high medication adherence rates: 1.70 (95% confidence interval [CI], 1.42–2.03) and 1.59 (95% CI, 1.14–2.20). Similar results were observed for each adherence item, including prefect dose (OR, 2.14; 95% CI, 1.73– 2.63), frequency (OR, 1.87; 95% CI, 1.53–2.28), time (OR, 1.72; 95% CI, 1.43–2.07), and no stop (OR, 1.56; 95% CI, 1.09–2.23)/high frequency (OR, 2.47; 95% CI, 1.21–5.01), time (OR, 2.30; 95% CI, 1.19–4.44). However, the place only group showed no significant differences in medication adherence except for perfect adherence to dose (OR, 1.35; 95% CI, 1.06–1.71).
Conclusion
These findings provide evidence supporting the need for healthcare policies that encourage having a regular doctor in South Korea, which has a healthcare system with limited primary care.

Citations

• Types of Usual Source of Care and Medication Adherence in Patients with Diabetes Mellitus
  Yoon-Eui Choi, Nak-Jin Sung
  Korean Journal of Family Practice.2025; 15(1): 47.     CrossRef
• Supply of Primary Care Physicians: A Key Strategy to Reduce Population Mortality
  Young Gyu Cho
  Korean Journal of Family Medicine.2024; 45(2): 59.     CrossRef

Background
A usual source of care (USC) is related to longitudinal and personalized services, which are attributes of primary care. Patient-centered communication, an important element of patient-centered care, helps physicians understand health problems from a patient’s point of view. We analyzed the association between USC and patient-centered communication.
Methods
Data from the Korea Health Panel 2018 were used in the analysis. Patient-centered communication scores were obtained by combining the four communication-related questionnaire items. Usual source of care types were categorized based on responses to two questionnaire items: no USC, a place without a regular doctor and with a regular doctor. Multiple logistic regression analysis was used to adjust for confounders.
Results
Good communication rate was higher for those with a regular doctor (71.8%) than for those with no USC (61.8%) or a place only (61.5%). Those with a regular doctor had better communication (odds ratio, 1.49 for individuals with poor/moderate health, and 2.08 for those with good health) than those without a USC after adjusting for confounders. In terms of communication, no difference was observed between individuals with no USC and those with a place only.
Conclusion
Having a regular doctor promotes communication between patients and doctors. Good communication may be a mediator between having a regular doctor and related beneficial outcomes. Better communication by having a regular doctor, along with several other benefits identified in previous studies suggests the need for a health policy that encourages individuals to have regular doctors.

Citations

• Types of Usual Source of Care and Medication Adherence in Patients with Diabetes Mellitus
  Yoon-Eui Choi, Nak-Jin Sung
  Korean Journal of Family Practice.2025; 15(1): 47.     CrossRef
• Correlation between Usual Source of Care and Medication Adherence in Patients with Hypertension
  Han-Kil Kang, Nak-Jin Sung
  Korean Journal of Family Medicine.2024; 45(2): 82.     CrossRef
• Determinants of Patient-Centered Communication, Its Impact On Quality of Services, Overall Health Status And Trust In The Healthcare System In The United States
  Cuma Çakmak, İsmail Biçer
  Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi.2024; 11(4): 630.     CrossRef

Background
Patients’ perceptions of care tend to correlate with the quality of care provided. Different health care systems and service environments may show different associations between types of usual source of care (USC) and overall service quality assessment. We attempted to analyze this association as a benefit of having a USC.
Methods
This study used the 2012 Korea Health Panel data version 1.1 as representative national household survey data. The total number of subjects aged 18 years or more was 12,708. The number of subjects in the final analysis was 10,665. Multiple logistic regression analysis was used to assess the association between types of USC and overall health care service quality. The main outcome variable was users’ ratings of the quality of health care service.
Results
People having a usual doctor (n=1,796) were more likely to positively assess the quality of health care they received than those not having a USC (n=7,920; odds ratio [OR], 1.39; 95% confidence interval [CI], 1.20–1.60) or with those having only a place as a USC without a usual doctor (n=949; OR, 1.29; 95% CI, 1.05–1.58) after adjustment for demographic characteristics and health-related variables.
Conclusion
People having a usual doctor rated overall health care service quality as high, which might be due to benefits of primary care attributes related to usual doctors. Further studies are needed to elucidate the causal relationship. This finding implies that health policies encouraging people to have a usual doctor are needed in Korea.

Citations

• Fatores determinantes no reconhecimento de uma fonte usual de cuidado por adolescentes brasileiros
  Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
  Ciência & Saúde Coletiva.2024;[Epub]     CrossRef
• Determinants factors in the recognition of a usual source of care by Brazilian adolescents
  Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
  Ciência & Saúde Coletiva.2024;[Epub]     CrossRef
• Ações intersetoriais e o reconhecimento de uma fonte de cuidado da atenção primária por adolescentes brasileiros
  Maísa Mônica Flores Martins, Nília Maria de Brito Lima Prado, Leila Denise Alves Ferreira Amorim, Ana Luiza Queiroz Vilasbôas, Rosana Aquino
  Cadernos de Saúde Pública.2024;[Epub]     CrossRef
• Types of usual sources of care and their association with healthcare outcomes among cancer survivors: a Medical Expenditure Panel Survey (MEPS) study
  Ambrish A. Pandit, Chenghui Li
  Journal of Cancer Survivorship.2023; 17(3): 748.     CrossRef
• How do perceptions of public health measures affect experience of unmet healthcare needs among older Korean adults during COVID-19 pandemic?
  Jongnam Hwang, Sujin Kim
  Preventive Medicine Reports.2022; 26: 101735.     CrossRef
• Public Perspectives on Decisions About Emergency Care Seeking for Care Unrelated to COVID-19 During the COVID-19 Pandemic
  Rebecca Gale, Samuel Eberlein, Garth Fuller, Carine Khalil, Christopher V. Almario, Brennan M.R. Spiegel
  JAMA Network Open.2021; 4(8): e2120940.     CrossRef

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• The NSCH patient-centered medical home scale: A measurement history, critique, and commentary
  Phillip M. Hughes, Genevieve Graaf, Kathleen C. Thomas
  Children's Health Care.2025; 54(2): 237.     CrossRef
• The gap is still here: Access to physical and mental health care for children and adolescents 15 years after the Affordable Care Act
  Amy Manning
  F1000Research.2025; 14: 167.     CrossRef
• The role of primary care attributes in preventing loss or change of usual source of care: a nationwide cohort study
  Takuya Aoki, Sota Zukeran, Masato Matsushima
  Family Practice.2024; 41(5): 726.     CrossRef
• Generating user-driven patient personas to support preventive health care activities of rural-living unattached patients
  Lindsay Burton, Kathy L. Rush, Cherisse L. Seaton, Eric P.H. Li, Kendra Corman, Charlene E. Ronquillo, Selena Davis, Mindy A. Smith
  PEC Innovation.2024; 4: 100274.     CrossRef
• Comprehensive Evidence-Based Health Maintenance
  Ami Schattner
  The American Journal of Medicine.2024; 137(8): 706.     CrossRef
• Users’ perception of quality as a driver of private healthcare use in Mexico: Insights from the People’s Voice Survey
  Svetlana V. Doubova, Hannah H. Leslie, Ricardo Pérez-Cuevas, Margaret E. Kruk, Catherine Arsenault, Steve Zimmerman
  PLOS ONE.2024; 19(6): e0306179.     CrossRef
• Age of Autism Spectrum Disorder Diagnosis and Patient-Centered Medical Home Components
  C. A. Limbers, T. Zeleznik, G. Beuley, A. Milliken, E. Hernandez, S. R. Ryan-Pettes
  Journal of Clinical Psychology in Medical Settings.2024;[Epub]     CrossRef
• Cross-Sectional Analysis of Difficulties Using Usual Source of Care for People with Disability
  Jane Ko, Jae-Hyun Park
  INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2024;[Epub]     CrossRef
• Asian American Self-Reported Discrimination in Healthcare and Having a Usual Source of Care
  Thomas K. Le, Leah Cha, Gilbert Gee, Lorraine T. Dean, Hee-Soon Juon, Winston Tseng
  Journal of Racial and Ethnic Health Disparities.2023; 10(1): 259.     CrossRef
• The relationship between having a usual source of primary care and COVID‐19 parental vaccine hesitancy: A nationwide survey among Japanese mothers
  Kenya Ie, Mio Kushibuchi, Tomoya Tsuchida, Iori Motohashi, Masanori Hirose, Steven M. Albert, Miyako Kimura
  Journal of General and Family Medicine.2023; 24(4): 215.     CrossRef
• Factors associated with the status of usual source of care during the COVID-19 pandemic: a nationwide survey in Japan
  Takuya Aoki, Masato Matsushima
  BMC Primary Care.2023;[Epub]     CrossRef
• Sociodemographic Characteristics and Inadequate Usual Sources of Healthcare in a National Sample of US Refugees
  Kyle J. Baumann, Tilahun Adera
  International Journal of Environmental Research and Public Health.2022; 19(12): 7234.     CrossRef
• A cross-sectional study of the preventive health care activities of western Canadian rural-living patients unattached to primary care providers
  Kathy L. Rush, Lindsay Burton, Cherisse L. Seaton, Mindy A. Smith, Eric P.H. Li, Charlene E. Ronquillo, Khalad Hasan, Selena Davis, Mona Mattei
  Preventive Medicine Reports.2022; 29: 101913.     CrossRef
• Determinants of choice of usual source of care among older people with cardiovascular diseases in China: evidence from the Study on Global Ageing and Adult Health
  Tiange Xu, Katya Loban, Xiaolin Wei, Wenhua Wang
  BMC Public Health.2022;[Epub]     CrossRef
• Factors Associated With Hearing Aid Use Among Medicare Beneficiaries
  Lama Assi, Nicholas S Reed, Carrie L Nieman, Amber Willink, Steven M Albert
  Innovation in Aging.2021;[Epub]     CrossRef
• Early Patient-Centered Outcomes Research Experience With the Use of Telehealth to Address Disparities: Scoping Review
  James E Bailey, Cathy Gurgol, Eric Pan, Shirilyn Njie, Susan Emmett, Justin Gatwood, Lynne Gauthier, Lisa G Rosas, Shannon M Kearney, Samantha Kleindienst Robler, Raymona H Lawrence, Karen L Margolis, Ifeyinwa Osunkwo, Denise Wilfley, Vallabh O Shah
  Journal of Medical Internet Research.2021; 23(12): e28503.     CrossRef
• Validating the New Primary Care Measure in the Medical Expenditure Panel Survey
  R. Henry Olaisen, Susan A. Flocke, Kathleen A. Smyth, Mark D. Schluchter, Siran M. Koroukian, Kurt C. Stange
  Medical Care.2020; 58(1): 52.     CrossRef
• The management of diabetes in everyday life study: Design and methods for a pragmatic randomized controlled trial comparing the effectiveness of text messaging versus health coaching
  James E. Bailey, Satya Surbhi, Justin Gatwood, Susan Butterworth, Mace Coday, Sohul A. Shuvo, Ankur A. Dashputre, Ian M. Brooks, Bonnie L. Binkley, Carrie Jo Riordan, Helmut O. Steinberg, Mary Lou Gutierrez, Lauren E. Haley, Cardella L. Leak, Elizabeth A.
  Contemporary Clinical Trials.2020; 96: 106080.     CrossRef
• States with fewer criminalizing immigrant policies have smaller health care inequities between citizens and noncitizens
  Maria-Elena De Trinidad Young, Hiram Beltrán-Sánchez, Steven P. Wallace
  BMC Public Health.2020;[Epub]     CrossRef
• Disconnected: a survey of users and nonusers of telehealth and their use of primary care
  Winston R Liaw, Anuradha Jetty, Megan Coffman, Stephen Petterson, Miranda A Moore, Gayathri Sridhar, Aliza S Gordon, Judith J Stephenson, Wallace Adamson, Andrew W Bazemore
  Journal of the American Medical Informatics Association.2019; 26(5): 420.     CrossRef
• The impact of the adoption of a patient rostering model on primary care access and continuity of care in urban family practices in Ontario, Canada
  Jatinderpreet Singh, Simone Dahrouge, Michael E. Green
  BMC Family Practice.2019;[Epub]     CrossRef
• Health needs, utilization of services and access to care among Medicaid and uninsured patients with chronic disease in health centres
  Hailun Liang, May A. Beydoun, Shaker M. Eid
  Journal of Health Services Research & Policy.2019; 24(3): 172.     CrossRef
• Trends in the Types of Usual Sources of Care: A Shift from People to Places or Nothing at All
  Winston Liaw, Anuradha Jetty, Stephen Petterson, Andrew Bazemore, Larry Green
  Health Services Research.2018; 53(4): 2346.     CrossRef
• The Effect of Having a Regular Doctor as a Primary Care Provider on Emergency Room Utilization in South Korea
  Su-Young Lee, Hyeong-Seok Lim
  Korean Journal of Family Medicine.2017; 38(6): 322.     CrossRef
• Unmet Primary Care Needs in Diabetic Patients with Multimorbidity in a Medically Underserved Area
  Bianca M. Jackson, Mary Lou Gutierrez, George E. Relyea, Erik L. Carlton, SangNam Ahn, Bonnie L. Binkley, James E. Bailey
  Health Services Research and Managerial Epidemiology.2017;[Epub]     CrossRef
• Having a usual source of care and its associated factors in Korean adults: a cross-sectional study of the 2012 Korea Health Panel Survey
  Ah Reum An, Kyoungwoo Kim, Jae-Ho Lee, Nak-Jin Sung, Sang-il Lee, Min Kyung Hyun
  BMC Family Practice.2016;[Epub]     CrossRef
• Community Health Center Utilization Following the 2008 Medicaid Expansion in Oregon: Implications for the Affordable Care Act
  Brigit Hatch, Steffani R. Bailey, Stuart Cowburn, Miguel Marino, Heather Angier, Jennifer E. DeVoe
  American Journal of Public Health.2016; 106(4): 645.     CrossRef
• Subgroup differences in having a usual source of health care among working-age adults with and without disabilities
  Konrad Dobbertin, Willi Horner-Johnson, Jae Chul Lee, Elena M. Andresen
  Disability and Health Journal.2015; 8(2): 296.     CrossRef
• The Influence of Health Systems on Hypertension Awareness, Treatment, and Control: A Systematic Literature Review
  Will Maimaris, Jared Paty, Pablo Perel, Helena Legido-Quigley, Dina Balabanova, Robby Nieuwlaat, Martin Mckee, Mark J. Caulfield
  PLoS Medicine.2013; 10(7): e1001490.     CrossRef

Background
Management of hypertension has been performed mainly in primary care institutions, but hypertension control in population is still unsatisfactory. This study was aimed at finding a strategy to improve health promotion activities in patients with hypertension by exploring the association between health behaviors and quality of primary care.Methods: April to June in 2007, a questionnaire survey of the patients who has a family physician as a usual source of care was conducted for the development of the Korean Primary Care Assessment Tool (KPCAT). In this study, a usual source of care was defined as a physician of the persons who had visited their primary care clinic on six or more occasions over a period of more than 6 months. Of the data collected from 9 private clinics (3 in Seoul and 6 at small cities), cases of the patients who marked on having hypertension were selected. The associations between levels of quality of primary care and socio-demographic characteristics or health behaviors were analysed by Student t-test and chi-square test. Controlling socio-demographic variables, the association between quality of primary care and health behaviors was examined by multiple logistic regression analysis.Results: Among the patients (n = 602) of 9 private clinics who has a family physician as a usual source of care, those who marked on having hypertension were 134. Among 5 domains of the KPCAT, the highest domain in score was personalized care (71.7/100), and the lowest domain in score was coordination function (49.7/100). In patients who gave total average (69.2/100) or more in total primary care score, after adjustment with age, sex, income, education, and duration, odds ratio to have a normal BMI (<25 kg/m2) was 2.53 (P = 0.02), and odds ratio to have a habit drinking an adequate amount of alcohol was 4.32 (P = 0.02). Conclusion: The fact that high-quality primary care was associated with good health behaviors in this study suggests that improving quality of primary care by health care reform can make health behaviors more desirable in patients with essential hypertension.

Citations

• Development of a Quality Assessment Tool for Hypertension Management by Public Healthcare Providers: A Cross-Sectional Survey
  Youngshin Song, Kawoun Seo
  Journal of Korean Academy of Fundamentals of Nursing.2023; 30(4): 437.     CrossRef
• Importance of a usual source of care in choosing low-priced generic drugs: a cross-sectional study
  Kyung-Bok Son, Eui-Kyung Lee
  Family Practice.2022; 39(5): 791.     CrossRef
• The Effect of Having a Regular Doctor as a Primary Care Provider on Emergency Room Utilization in South Korea
  Su-Young Lee, Hyeong-Seok Lim
  Korean Journal of Family Medicine.2017; 38(6): 322.     CrossRef
• Patients' Perceived Quality of Family Physicians' Primary Care with or without 'Family Medicine' in the Clinic Name
  Ka Young Kim, Kangjin Lim, Eal Whan Park, Eun Young Choi, Yoo Seock Cheong
  Korean Journal of Family Medicine.2016; 37(5): 303.     CrossRef
• Primary care research in South Korea: its importance and enhancing strategies for enhancement
  Yu-Il Kim, Jee Young Hong, Kyoungwoo Kim, Eurah Goh, Nak-Jin Sung
  Journal of the Korean Medical Association.2013; 56(10): 899.     CrossRef
• Higher quality primary care is associated with good self-rated health status
  N. J. Sung, J. F. Markuns, K. H. Park, K. Kim, H. Lee, J. H. Lee
  Family Practice.2013; 30(5): 568.     CrossRef
• Patient assessment of primary care under the Designated Practice Scheme for Medical Aid beneficiaries, using the Korean Primary Care Assessment Tool (K-PCAT): a district of Seoul, South Korea
  Jae-Ho Lee, Yong-Jun Choi, Ji-Sook Choi, Sera Kim
  Journal of the Korean Medical Association.2012; 55(2): 187.     CrossRef
• The Impact of Bladder Distension on Blood Pressure in Middle Aged Women
  Eun Jung Choi, Dong Wook Jeong, Jeong Gyu Lee, Sangyeoup Lee, Yun Jin Kim, Yu Hyone Yi, Young Hye Cho, Sun Ju Im, Mi Jin Bae
  Korean Journal of Family Medicine.2011; 32(5): 306.     CrossRef
• Factors associated with the hypertension outpatients' choice of healthcare providers in Korea
  Jung Chan Lee, Kye Hyun Kim, Han Nah Kim, Yoon Hyung Park
  Journal of the Korean Medical Association.2011; 54(9): 961.     CrossRef

Background
In South Korea, major health care problems have been occurred under the structural background that medical services are mainly provided by private medical institutions. Primary health care, which is very crucial in public health, has been overlooked, and is disorganized and fragmented. In the mean time, health cooperative movement was initiated by local residents and medical doctors to overcome health care problems in 1987. We conducted this study to evaluate the role of health cooperative clinics and obtain lessons for the future primary care policy. Methods: During April to June in 2007, survey was performed by a trained interviewer at the waiting rooms of 3 health cooperative clinics, in the process of development of the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of 5 domains (21 items): first contact (5), coordination function (3), comprehensiveness (4), family/community orientation (4), and personalized care (5). Subjects were patients (or guardians) who had visited their health cooperative clinics on six or more occasions over a period of more than 6 months. We compared primary care scores of each domain between members and non-members of health cooperative clinics by student t-test. Effect of having a membership on each primary care domains was examined by multiple regression analysis. Results: Among the participants (N = 100), members of health cooperatives were 48, and non-members 52. Total average scores of 5 primary care domains of the KPCAT were 78.0 ± 13.5 on 100 point scale. (82.0 ± 13.1 in members, and 74.3 ± 13.0 in nonmembers; P = 0.004) Among primary care domains, personalized care was the highest (91.4 ± 11.0), and coordination function the lowest (61.0 ± 33.1) in score. Significant differences between members and nonmembers were noted in coordination function (68.9 vs. 53.7, P = 0.021) and comprehensiveness (78.4 vs. 67.2, P = 0.008). These differences were continued after adjusting by multiple regression analysis for socio-demographic variables including age, sex, income, education, number of disease, and duration since the first visit. Conclusion: In the health cooperative clinics whose primary care performance has been considered exemplary in the context of health care in South Korea, primary care scores assessed by members were higher than those by non-members. The significant differences of scores in coordination function and comprehensiveness between members and non-members suggest that the future primary care policy should be focused to strengthen these two domains of primary care.

Citations

• Evaluation of Value-Based, Community-Centered Primary Care: A Case Study of Anseong Health Welfare Social Cooperative
  Jong-Han Leem, Soon ho Lee, Min Kyung Lim, Eunbyoul Ahn, Younhee Kim
  Korean Journal of Family Practice.2024; 14(2): 66.     CrossRef
• The Importance of the South Korean Primary Care Group and the Korean Primary Care Assessment Tool: Is It Possible to Sample the Whole Country?
  Erno Harzheim, Luiz Felipe Pinto, Otávio Pereira D’Avila, Lisiane Hauser
  Korean Journal of Family Medicine.2021; 42(2): 183.     CrossRef
• Patients' Perceived Quality of Family Physicians' Primary Care with or without 'Family Medicine' in the Clinic Name
  Ka Young Kim, Kangjin Lim, Eal Whan Park, Eun Young Choi, Yoo Seock Cheong
  Korean Journal of Family Medicine.2016; 37(5): 303.     CrossRef
• General Internists' Perspectives Regarding Primary Care and Currently Related Issues in Korea
  Jin Yong Lee, Sang Jun Eun, Minsu Ock, Hyun Joo Kim, Hyeon-Jeong Lee, Woo-Seung Son, Min-Woo Jo
  Journal of Korean Medical Science.2015; 30(5): 523.     CrossRef
• Factors Influencing Union Members' Participation in the Korean Health Cooperatives
  Kwang-Myo Kim, Eunyoung Park, Kun-Sei Lee, Myoungsoon You, Chang-Yup Kim
  Health Policy and Management.2014; 24(4): 330.     CrossRef
• Patient assessment of primary care under the Designated Practice Scheme for Medical Aid beneficiaries, using the Korean Primary Care Assessment Tool (K-PCAT): a district of Seoul, South Korea
  Jae-Ho Lee, Yong-Jun Choi, Ji-Sook Choi, Sera Kim
  Journal of the Korean Medical Association.2012; 55(2): 187.     CrossRef