- Date2025-02-14
Publication of 2023 Appropriateness Review Result of Asthma and
Chronic Obstructive Pulmonary Disease (COPD)
- Pulmonary Function Tests Going Up and Continuous Out-Patient Visits Going Down -
□ The Health Insurance Review and Assessment Service (HIRA), led by President Kang Jung-Gu, gives publicity to the Tenth Asthma appropriateness review result and the Ninth COPD result on the HIRA portal and its mobile application on the 25th of October, 2024.
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<Main Content> ▪Subject of Assessment - (Period) Jan-Dec 2023 (Out-patient records for 12 months) - (Subject) patients with Asthma (over 15 years-old); COPD (over 40 years-old) as major or secondary disease who saw a doctor in medical institutions - (Institutions) Medical institutions with out-patient records of Asthma; COPD as major or secondary disease Asthma: 17,068 places; and COPD: 6,339 places ▪Assessment Result - (Subject of Publication) Institutions with over 5 persons of the subject; and the result of 3 assessment indicators Asthma: 9,805 places (only clinics) ; and COPD: 1,848 places - (Total Score on Average) Asthma: 48.0 points ; and COPD: 69.4 points - (Assessment Grade) Asthma: 1,802 as 1st Grade out of 9,805 places (18.4%) COPD: 642 as 1st Grade out of 1,848 places (34.7%) |
□ Korean prevalence rate of Asthma and COPD as a main chronic respiratory disease (CRD) is higher in older population and the number of relevant patients are expected to continue to mount due to a hike in aging population and air pollution.
* 3.1% of prevalence rate of Asthma over 19 years-old and 4.0% over 65 years-old 12.7% of prevalence rate of COPD over 40 years-old and 25.6% over 65 years-old
○ Constant out-patient medical services of Asthma and COPD can prevent worsening diseases and hospital admission. To this end, the HIRA conducts the assessment of appropriateness since 2013 in an effort to manage quality of medical care of aforementioned two diseases.
□ The Tenth Assessment of Asthma and the Ninth of COPD recently made public targeted out-patient records performed during January-December 2023 and the following assessment indicators were applied: the implementation rate of pulmonary function tests (PFTs); the ratio of a patient who constantly visits a medical institution; and the rate of a patient for whom an inhalent was prescribed.
□ The results of the Tenth Assessment of Asthma and the Ninth of COPD found that there was an increase in the implementation rate of clinic-wide PFTs, there being a decrease in the ratio of a patient who continued to pay a visit to a health care provider and a rise in the rate of a patient with an inhalent prescription, which is confined to COPD.
○ (Implementation rate of PFTs) It is essential to conduct PFTs more than once a year to make an early diagnosis of CRD and manage pertinent diseases.
- The rate of asthma hit 41.5 % and COPD 80.3%, 18.0%p and 21.6%p up from the 1st assessment, respectively. A by-clinic portion of the entire PFTs implementation rate is lower, and yet the by-clinic ratio saw an increase in both diseases in comparison with the previous assessment.
○ (Rate of a continuous visiting patient) Out-patient management is crucial of precluding worsening diseases and developing complications.
- The rate of asthma hit 74.4 % and COPD 80.2%, 2.8%p and 2.4%p down from the 1st assessment, respectively, along with the by-clinic rate lower in both diseases.
- These decreases most likely transpired led by a patient who made a selective visit to a hospital following his or her level of a symptom, possibly discounting the necessity of firm diseases control. Hence, there is a need for a change in a patient’s recognition and robust management for a patient by a hospital and medical staff members.
○ (Ratio of a patient with an inhalent prescription) Pulmonary function in CRD can improve by the use of a proper inhalent at the beginning of a diagnosis, thereby worsening unless an inhalent is continuously used.
- The rate of a patient with an inhaled steroid prescription in asthma reached 51.8% and the proportion of a patient who was prescribed an inhaled broncodilator for in COPD 91.5%, 26.4%p and 23.6%p up from the 1st assessment, respectively.
□ The HIRA enables a patient with CRD to gain a steady management serviced by a hospital or a clinic offering quality of care by making clinics for Asthma public and hospitals and clinics for COPD, in a separate grade from 1 to 5 for both diseases.
○ Taking regional leading institutions*, there are 1,802 institutions for Asthma and 642 institutions for COPD nationwide. Taking each regional prominent provider into consideration, it is recommended to see a doctor in the nearest area.
* the 1st grade clinics for Asthma and 1st grade hospitals and clinics for COPD
<Status of Regional Leading Institutions for Asthma>
|
Category |
Nationwide |
Seoul |
Gyeongin |
Gangwon |
Chungcheong |
Gyeongsang |
Jeolla |
Jeju | |
|
Total |
9,805 |
2,028 |
2,978 |
256 |
1,058 |
2,348 |
1,015 |
122 | |
|
Leading institutions |
Number of institutions |
1,802 |
461 |
560 |
37 |
167 |
407 |
154 |
16 |
|
Selection rate |
18.4 |
22.7 |
18.8 |
14.5 |
15.8 |
17.3 |
15.2 |
13.1 | |
<Status of Regional Leading Institutions for COPD>
|
Category |
Nationwide |
Seoul |
Gyeongin |
Gangwon |
Chungcheong |
Gyeongsang |
Jeolla |
Jeju | |
|
Total |
1,848 |
254 |
430 |
68 |
242 |
530 |
308 |
16 | |
|
Leading institutions |
Number of institutions |
642 |
106 |
158 |
19 |
86 |
172 |
91 |
10 |
|
Selection rate |
34.7 |
41.7 |
36.7 |
27.9 |
35.5 |
32.5 |
29.5 |
62.5 | |
□ Director General of Quality Assessment Administration Department of HIRA stated “In the assessment result of CRD, the implementation rate of PFTs rose, and yet there was a decrease in the ratio of a continuous visiting patient and a patient who was prescribed an inhalent for, which draws more attention to quality of care for CRD.
○ She also added “With the goal of a shift in public recognition, the HIRA is committed to widely spreading the information to manage and prevent CRD by handing out promotion materials including posters and leaflets as well as by continuing to support various projects to accelerate quality of care of medical institutions falling short of quality service.”
