Evaluation of nationwide quality control indicators of asthma treatment

Le résumé fourni par la source

Background: Health Insurance Review and Assessment service (HIRA) in Korea has been monitored the quality of asthma management using National health insurance claim data in each level of care, such as measuring the pulmonary function test rate, prescribed medications, and the rate of hospital visits. However, the adequacy of quality control indicators has not been evaluated. Methods: We investigated the HIRA data (health insurance claim records) every year from July 2013 to June 2016. Each medical institution was evaluated and assigned as excellent group and non-excellent group by the quality control indicators. We created the operational definition of asthma severity using rank-sum of medications and exacerbation episode using asthma-related hospitalization and drugs used in asthma exacerbation. The rate of asthma exacerbation and asthma severity were evaluated in each group. Results: The claim data of asthma patients were collected yearly and compared (n=814,395, n=835,243, n=802,761 patients in each period). The rate of asthma exacerbation was higher in excellent group than non-excellent group. The asthma severity was higher in excellent group. After adjusting asthma severity, there was no significant correlation between the rate of asthma exacerbations and the level of the assessment indicators by HIRA. Conclusions: The nationwide quality control indicators require improvement considering severity of asthma.

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