Influence of government-driven quality assessment program on patients with chronic obstructive pulmonary disease

Respiratory Research

Hye Sun Lee¹  Hye Jung Park²  Jae-Hyun Lee³  Sung-Ryeol Kim³  Jung-Won Park³  Sinae Kim⁴  Hye Kyoung Kim⁵  Ji Hyeon Shin⁵  Bo Yeon Kim⁵  Sang In Ahn⁵ 

[1] Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea;Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea;Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;Institute of Allergy, Yonsei University College of Medicine, Seoul, Republic of Korea;Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;Healthcare Insurance Review and Assessment Service, Wonju, Republic of Korea;

关键词: Chronic obstructive pulmonary disease;    Quality assessment;    Prognosis;    Clinical outcome;    Mortality rate;   

DOI  :  10.1186/s12931-021-01684-1

来源: Springer

【 摘 要 】

BackgroundThe Korean Health Insurance Review and Assessment Service (HIRA) has launched the Chronic Obstructive Pulmonary Disease (COPD) Quality Assessment Program (CQAP) since 2014. We aimed to reveal the influence of this national program on clinical outcomes and the burden of COPD in Korea.MethodsThe CQAP is conducted annually. We used healthcare claims data linked with the results of the program provided by HIRA between May 2014 and April 2017. Patients were considered to have COPD if they visited a hospital for COPD management during the assessment term. Those who visited a medical institution for COPD and were prescribed COPD medications at least twice were assessed by the CQAP (assessed subjects, AS; not-assessed subjects, NAS). CQAP evaluated the pulmonary function test conduction rate, regular visitation rate, and prescription rates of COPD medications.ResultsAmong the 560,000 patients with COPD, about 140,000 were assessed by the CQAP annually. In both groups, the pulmonary function test conduction rate and inhaled bronchodilator prescription rate improved since 2014. Compared to the NAS group, the risk of admission and all-cause mortality rate in the AS group were significantly reduced by 21.2% and 40.7%, respectively. In patients who were assessed for 3 consecutive years, all of the above variables were high at baseline and were not improved much from implementation of CQAP. In matching analysis, we observed this improvement to be limited in the COPD quality assessment year.ConclusionsThe CQAP by the health insurance bureau has improved the management protocol and prognosis of COPD.

【 授权许可】

CC BY