- Date2025-02-17
Publication of 2023 Appropriateness Review Result
of Tuberculosis
- Out of 10 Institutions going publicity of assessment, More than 6 Institutions Marked as 1st Grade -
□ The Health Insurance Review and Assessment Service (HIRA), led by President Kang Jung-Gu, gives publicity to the 2023(Sixth) Tuberculosis appropriateness review result on the HIRA portal and its mobile application on the 30th of October, 2024.
|
<Main Content> ▪ Subject of Assessment - (Period) Jan-Jun 2023 (in-patient and out-patient records for 6 months) - (Subject) 6,573 persons of newly recorded patients contracting tuberculosis to Korea Centers for Disease Control and Prevention (KCDA) -(Institutions) 505 medical institutions under relieved co-payment policy for tuberculosis ▪ Assessment Result -(Subject of Publication) 216 Institutions with over 5 cases of the assessment subject who used a single institution -(Total Score) 94.3 points on average -(Assessment Grade) 137 institutions marked as 1st out of 216 (63.4%) |
□ Tuberculosis is an air-borne infection emerged by mycobacterium tuberculosis complex, of which an early examination can make a diagnosis, and most likely being cured by taking anti-tuberculosis drugs consistently.
○ The ratio of Korean patients contracting tuberculosis appears to be at a high level, being placed 2nd in emergence rate and 4th in mortality rate among OECD countries, and constant prevention and control policies and appropriateness assessment in regards to tuberculosis have been laid out to ensure a steady decline of the number of a new patient developing tuberculosis, reaching below the half down from the 2011 levels at a record high.
* Records status of the new patients: 78.9 persons of 2011 → 30.6 persons of 2023 (per 100,000 people)
□ The HIRA efficiently bolsters the national tuberculosis management policy and draws rapid and accurate diagnosis of the new patients and standardized treatment with the purpose of containing early infectiousness and emergence rate of mycobacterium tuberculosis complex, conducting tuberculosis appropriateness assessment.
○ This Sixth assessment result is made public based upon diagnosis records of from January to June 2023. This is the second result publication open to the public, following the 5th result.
○ The following assessment indicators were applied: accuracy of diagnosis – which includes a mycobacterium tuberculosis complex examination rate, a conventional susceptibility test rate, and a rapid susceptibility test rate; the level of managing patients with tuberculosis using a drug administration day rate; the result of treatment built upon successful treatment rate (within a year after definite diagnosis), as a first monitoring indicator in the Sixth.
□ The assessment result indicated that the overall score is 94.3 points on average and the 1st graded institutions hit 137 places (63.4%).
○ The institutions are distributed evenly across the nation: 28 places in Seoul, 41 places in Gyeonggi-do, 36 places in Gyeongsang-do, and so forth.
<Distribution Status of Regional 1st Graded Medical Insitutions>
TT(Unit: place, %)
|
Category |
Nationwide |
Seoul |
Gangwon |
Gyeonggi |
Gyeongsang |
Chungcheong |
Jeolla |
Jeju |
|
Total |
216 |
40 |
7 |
62 |
58 |
23 |
23 |
3 |
|
1st Grade |
137(63.4) |
28(70.0) |
4(57.1) |
41(66.1) |
36(62.1) |
14(60.9) |
12(52.2) |
2(66.7) |
□ All assessment indicators had the better result than the Fifth one, in particular, with 90.7% of the rapid susceptibility test rate, 4.8% up from the previous assessment result.
(Unit: %, %p)
|
Category |
Indicator |
Order of Assessment |
Increase and decrease (B-A) | ||||||
|
1st |
2nd |
3rd |
4th |
5th(A) |
6th(B) | ||||
|
Assessment Indicator (4) |
Accuracy of Diagnosis |
① Mycobacterium tuberculosis complex examination rate |
- |
- |
- |
- |
95.4 |
96.0 |
0.6▲ |
|
② conventional susceptibility test rate |
- |
- |
84.8 |
89.5 |
90.8 |
92.9 |
2.1▲ | ||
|
③ rapid susceptibility test rate |
- |
- |
- |
83.0 |
85.9 |
90.7 |
4.8▲ | ||
|
Management Level of Patients with Tuberculosis |
④ drug administration day rate |
95.9 |
95.9 |
96.1 |
95.9 |
95.7 |
96.3 |
0.6▲ | |
|
Monitoring Indicator (1) |
Result of Treatment |
⑤ successful treatment rate(within a year after definite diagnosis) |
- |
- |
- |
- |
- |
78.3 |
- |
○ (Accuracy of Diagnosis) It reviews accuracy of diagnosis of Tuberculosis including early examination indicators to diagnose Tuberculosis as well as examination indicators to make a diagnosis of drug-resistant Tuberculosis*.
* Drug-resistant Tuberculosis: Tuberculosis stemming from mycobacterium tuberculosis complex tolerant to anti-tuberculosis drugs
- Mycobacterium tuberculosis complex examination rate – which covers the combined ratio of AFB Smear, AFB Culture and NAAT – is 96.0%, 0.6% up from the Fifth assessment result.
- Compared with the previous result, a conventional susceptibility test rate reaches 2.1%p (92.9% from 90.8%), a rapid susceptibility test rate 4.8%p (90.7% from 85.9%). These two examinations play a pivotal role in not just diagnosing drug-resistant tuberculosis as a crucial part of tuberculosis management, but selecting pharmaceuticals. Yet result values of institutions not greater than a hospital grade is lower, leading to underpinning improvement and a quality of care project spurred by the institutions.
○ (Management Level of Patients with Tuberculosis) The assessment focused on the continuous drug-taking management for the new patients to cure tuberculosis, the Fifth result in a drug administration day rate growing by 0.6% (96.3% from 95.7%) in comparison to the previous one.
○ (Result of Treatment) A successful treatment rate (within a year after definite diagnosis) is a monitoring indicator first introduced to the Sixth review, which defines the rate of patients with a successful treatment result within a year from the tuberculosis-diagnosing day, and this indicator showed a result value of 78.3%.
□ Director General of Quality Assessment Administration Department of HIRA stated “All grade and indicator results of the Sixth Tuberculosis Appropriateness Assessment improved. These positive outcomes most likely came in after the HIRA was committed to continuing to derive standardized medical services and relevant patients management through the appropriateness assessment.”
○ She also set forth“The HIRA pledges to enable the public to select prominent institutions and gain medical services of a high quality driven by quality of medical care and enhancement of the review.”
