Epidemiology and Health

Original Articles

Evaluation of a telemedicine pilot project for hypertension in Korea: a nationwide real-world data study: Jeong-Yeon Kim, Yeryeon Jung, Seongwoo Seo, Youseok Kim, Min Jung Ko, Hun-Sung Kim; Epidemiol Health. 2025;47:e2025048. Published online August 25, 2025; DOI: https://doi.org/10.4178/epih.e2025048

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Abstract

OBJECTIVES
A telemedicine pilot project has received temporary authorization in Korea. The clinical effectiveness of telemedicine is well established; however, ongoing research must assess medical utilization, sustainability, prescription continuity, and safety.

METHODS

This study evaluated medical utilization, sustainability, prescription continuity, and safety before and after the implementation of a telemedicine pilot project between June 2022 and December 2023. Data were obtained from the Korean National Health Insurance Service (NHIS), and participants were divided into those who received non-face-to-face hypertension treatment at least once and those who did not.

RESULTS

This study included 124,210 patients diagnosed with hypertension who received telemedicine (the Tele_G group) and 124,210 propensity score-matched control individuals. The difference-in-difference (DID) for medical utilization between the Tele_G and control groups was 0.10 (-0.03 vs. -0.12, p<0.001). The DID for the Modified Modified Continuity Index was -0.005 (-0.003 vs. 0.002, p<0.001), while that for Most Frequent Provider Continuity was -0.006 (-0.004 vs. 0.002, p<0.001). The DID for the prescription day rate was 0.41 (-0.61 vs. -1.02, p<0.001), and that for the appropriate prescription continuation rate was 0.52 (-1.23 vs. -1.75, p<0.01).

CONCLUSIONS

Telemedicine did not fully achieve the same standard as face-to-face treatment for hypertension management; however, it showed comparable safety, suggesting potential as secondary care. As the first NHIS-based study on this topic in Korea, this research highlights the benefits of telemedicine when appropriately utilized for patients with hypertension. Nevertheless, due to limitations regarding long-term continuity and policy design, cautious interpretation is required, and further prospective studies are warranted.

Summary

Korean summary
비대면진료는 대면진료를 완전히 대체하지 않고, 특히 만성질환 관리에서 추적관찰을 보완하는 역할을 한다. 비대진료는 안정적인 고혈압 환자나 원거리 거주 환자에게 특히 유용하지만, 안전한 시행을 위해서는 의사 중심의 가이드라인과 정책이 필수적이다.

Key Message
This study evaluates the clinical impact of a telemedicine on hypertension management, focusing on medical utilization, prescription continuity, and patient safety using real-world data from the Korean National Health Insurance Service. This study’s findings show statistically significant differences in key outcomes such as medical utilization and prescription adherence between telemedicine and control groups. Specifically, telemedicine participants demonstrated better continuity in appropriate prescriptions and fewer barriers to consistent care compared to those receiving face-to-face care. These findings suggest that, when appropriately implemented, telemedicine may provide care that is comparable to or supportive of conventional face-to-face care for stable hypertensive patient.

Citations

Citations to this article as recorded by

Telemedicine for hypertension: opportunities and responsibilities in management
Jiwon Shinn, Hakyoung Park, Hun-Sung Kim
Cardiovascular Prevention and Pharmacotherapy.2025; 7(4): 155. CrossRef

Relations of Pulse Wave Velocity to Waist Circumference Independent of Hip Circumference: Min Jung Ko, Mi Kyung Kim, Jinho Shin, Bo Youl Choi; Epidemiol Health. 2010;32:e2010004. Published online May 3, 2010; DOI: https://doi.org/10.4178/epih/e2010004

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>Little is known about the effect of waist circumference (WC) on brachial artery pulse wave velocity (baPWV) independent of hip circumference (HC). Therefore, this study aimed to dissociate specific effect of WC on baPWV independent of HC.</sec><sec><title>METHODS</title>Of 1,053 rural residents (2004-2005), 777 subjects with no known history of coronary artery diseases or diabetes mellitus over 40 yr were included. To reduce collinearity, we assessed the independent effect of WC with HC on PWV by residual method (WC [RM]).</sec><sec><title>RESULTS</title>In women, most correlation coefficients were significant between measures of abdominal obesity and baPWV, with the highest (0.32) in waist to hip ratio (WHR), whereas no significance was found in men. All mean values of baPWV among the abdominally obese were higher than those of normal group in women, which were in the order of WHR, WC (RM), and WC. Adjusted OR with 95% CI for baPWV was significantly elevated by increase of WC (RM) upto 4.8 (95% CI: 2.1-11.2), and as 4.3 by WHR (95% CI: 1.6-11.4).</sec><sec><title>CONCLUSION</title>Considering the difficulty in biologically interpreting WHR, WC (RM) may be a useful indicator of abdominal obesity among females in that it reflects the risk of pulse wave velocity.</sec>

Summary

Citations

Citations to this article as recorded by

Cardiometabolic risk factors, peripheral arterial tonometry and metformin in adults with type 1 diabetes participating in the REducing with MetfOrmin Vascular Adverse Lesions trial
David Chen, Alicia J Jenkins, Nicola Greenlaw, Katie Dudman, Tamsin Fernandes, David M Carty, Alun D Hughes, Andrzej S Januszewski, Coen DA Stehouwer, John R Petrie
Diabetes and Vascular Disease Research.2023;[Epub] CrossRef
Relationship between anthropometric indices and arterial stiffness: Insights from an epidemiologic study
Sahar Sobhani, Saba Vakili, Dina Javid Jam, Reihaneh Aryan, Majid Khadem‐Rezaiyan, Saeid Eslami, Maryam Alinezhad‐Namaghi
Obesity Science & Practice.2022; 8(4): 494. CrossRef
Metabolic syndrome is related to vascular structural alterations but not to functional ones both in hypertensives and healthy subjects
Alessandro Maloberti, Michele Bombelli, Paola Vallerio, Martina Milani, Iside Cartella, Giovanni Tavecchia, Chiara Tognola, Enzo Grasso, Jinwei Sun, Benedetta De Chiara, Salvatore Riccobono, Guido Grassi, Cristina Giannattasio
Nutrition, Metabolism and Cardiovascular Diseases.2021; 31(4): 1044. CrossRef
High Systolic Blood Pressure is Associated with Increased Cardio-ankle Vascular Index in the Elderly
Thapanee Roengrit, Ruchada Sri-amad, Nawiya Huipao
Artery Research.2021; 27(1): 25. CrossRef
Effect of carbohydrate restriction-induced weight loss on aortic pulse wave velocity in overweight men and women
Majid M. Syed-Abdul, Qiong Hu, Miriam Jacome-Sosa, Jaume Padilla, Camila Manrique-Acevedo, Colette Heimowitz, Elizabeth J. Parks
Applied Physiology, Nutrition, and Metabolism.2018; 43(12): 1247. CrossRef
Changes in truncal obesity and fat distribution predict arterial health
Frank E. Corrigan, Heval Mohamed Kelli, Devinder S. Dhindsa, Robert E. Heinl, Ibhar Al Mheid, Muhammad Hammadah, Salim S. Hayek, Salman Sher, Danny J. Eapen, Greg S. Martin, Arshed A. Quyyumi
Journal of Clinical Lipidology.2017; 11(6): 1354. CrossRef
The role of abnormal metabolic conditions on arterial stiffness in healthy subjects with no drug treatment
Hyo-Sang Hwang, Kwang-Pil Ko, Myeong Gun Kim, Sihun Kim, Jeonggeun Moon, Wook Jin Chung, Mi Seung Shin, Seung Hwan Han
Clinical Hypertension.2016;[Epub] CrossRef
Effects of Short-Term Exenatide Treatment on Regional Fat Distribution, Glycated Hemoglobin Levels, and Aortic Pulse Wave Velocity of Obese Type 2 Diabetes Mellitus Patients
Ju-Young Hong, Keun-Young Park, Byung-Joon Kim, Won-Min Hwang, Dong-Ho Kim, Dong-Mee Lim
Endocrinology and Metabolism.2016; 31(1): 80. CrossRef
Abdominal obesity vs general obesity for identifying arterial stiffness, subclinical atherosclerosis and wave reflection in healthy, diabetics and hypertensive
Jose I Recio-Rodriguez, Manuel A Gomez-Marcos, Maria C Patino-Alonso, Cristina Agudo-Conde, Emiliano Rodriguez-Sanchez, Luis Garcia-Ortiz
BMC Cardiovascular Disorders.2012;[Epub] CrossRef
Prevalence and Determinants of Hyperlipidemia in Moderate Altitude Areas of the Yunnan-Kweichow Plateau in Southwestern China
Bingjun Deng, Tingguang Luo, Yanfei Huang, Tianhang Shen, Jing Ma
High Altitude Medicine & Biology.2012; 13(1): 13. CrossRef

Review

The Role of Epidemiology against Emerging and Reemerging Diseases.: Joung Soon Kim, Min Jung Ko; Korean J Epidemiol. 2001;23(1):1-22.

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Abstract PDF: Abstract
PURPOSE
Due to remarkable developments in technology and great efforts made by Health Organizations, most of infectious diseases had been under control. However, ecological changes and biological variations resulted in emerging and re-emerging infectious diseases, which threaten the global health and may have the possibility of being abused as biological weapon. Therefore it is indispensable to understand the latest information and knowledge in order to cope with the emergency situation.
RESULTS
In Korea, several reemerging diseases such as Malaria, Hepatitis A, Shigellosis, Mumps, and food poisoning has been increasing conspicuously since 1990. Also Diphtheria, plague, yellow fever and dengue fever have been potential threats, considering substantial international trades.
CONCLUSION
There have many newly emerged and re-emerged infectious diseases identified in recent few decades in Korea. Thus as epidemiologic professionals, we have to get ready, particularly following missions to be carried out : 1) to keep eyes open to look for emerging and reemerging diseases continuously and keep up the latest global information, 2) establish the co-operational organizations to prepare immediate action against the sudden outbreak, 3) publicize, educate, establish and perform the missions, taking initiative in training clinicians, 4) upgrade professional competency by familiarizing ourselves with epidemiologic investigations, and 5) fulfill the responsibilities as health keepers of the nation.; Summary

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