- Date2025-11-18
Results of the 1st Evaluation of Breast and Liver Cancer in the 2nd Cycle Released
– Transitioning from Surgery-Centered to Patient- and Outcome-Centered Cancer Care Evaluation: Completion of the First Assessments for the Five Major Cancers –
□ The Health Insurance Review and Assessment Service (HIRA, President Kang Joong-gu) announced on the 21st that the results of the first evaluation of breast and liver cancer adequacy in the second assessment cycle (based on 2023 treatment data) have been released through the HIRA website.*
* HIRA website (www.hira.or.kr) → Medical Information → Medical Evaluation Information → Hospital Evaluation Search/Guide → Cancer Diseases
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Main Details of the 1st Evaluation of Breast and Liver Cancer (2nd Cycle, 2023)
▪ Evaluation Scope ◦ (Period) January–December 2023 (12 months) ◦ (Patients) Inpatients aged 18 or older treated for primary breast or liver cancer ◦ (Institutions) Tertiary general hospitals, general hospitals, hospitals, and clinics that provided cancer treatment and claimed medical expenses
▪Main Evaluation Items
▪Results
▪ HIRA website (www.hira.or.kr), Hospital Quality Assessment Portal (https://khqa.kr), and mobile app (Health e-Eum) |
□ Cancer remains the leading cause of death in Korea and has been the focus of national attention. HIRA initiated cancer adequacy evaluations in 2011 and, since July 2022, has transitioned from a surgery-centered evaluation to a patient- and outcome-centered evaluation covering the entire cancer care process as part of the 2nd-cycle assessments.
〇 The current 1st evaluation of breast and liver cancer in the 2nd cycle, like the previously released evaluations for colorectal, gastric, and lung cancer (released in December 2024), assesses and publishes both common indicators* and cancer-specific indicators.
* Common indicators: Applied across the five major cancers (colorectal, gastric, lung, breast, and liver)
** Specific indicators: Reflect characteristics of each cancer type and its treatment
□ The 2nd-cycle 1st evaluation for breast and liver cancer targeted tertiary hospitals, general hospitals, hospitals, and clinics that provided cancer treatment and submitted medical claims between January and December 2023.
〇 A total of eight evaluation indicators were used, including process indicators from the patient’s perspective (such as education and counseling) and outcome indicators (such as readmission rates after surgery).
〇 Indicators related to end-of-life care, including hospice counseling and ICU utilization before death, were also monitored.
※ See [Appendix 1] for detailed indicator results
□ The overall comprehensive score of the first evaluation of breast cancer in the second cycle was 88.13 points, and 58.3% of all evaluated institutions received Grade 1.
〇 A review of the regional distribution of breast cancer assessment grades shows that, among the total 81 Grade 1 institutions nationwide, the majority were concentrated in the Seoul, Gyeonggi, and Gyeongsang regions.
□ Considering that the liver cancer adequacy assessment was conducted for the first time using newly introduced indicators for the majority of the first evaluation of the second cycle, HIRA will disclose the national-level results.*
* Indicator Expansion: (1st cycle) 1 indicator (surgical mortality) → (2nd cycle) 15 indicators (including the surgical mortality indicator)
〇 For liver cancer, HIRA plans to review and refine its evaluation approach and methodology for the next assessment cycle, taking into account the specific characteristics of this cancer type, which involves a wide range of treatment modalities, including surgery and transarterial chemoembolization (TACE)
□ The first-cycle evaluation of the five major cancers holds significance as it marks the completion of the transition from a surgery-centered assessment to a comprehensive, patient- and outcome-centered evaluation of cancer care. Based on the results of this initial evaluation, HIRA will actively incorporate necessary improvements by充分 reflecting feedback from the medical field, particularly for indicators identified as requiring refinement.*
* Multidisciplinary Care Target Criteria: (Current) All cancer patients → (Improved) Establishing criteria for patients requiring multidisciplinary care, and other related improvements.
