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

 Hye Jung Park  ;  Sung-Ryeol Kim  ;  Sinae Kim  ;  Hye Sun Lee  ;  Bo Yeon Kim  ;  Hye Kyoung Kim  ;  Sang In Ahn  ;  Ji Hyeon Shin  ;  Jae-Hyun Lee  ;  Jung-Won Park 
 RESPIRATORY RESEARCH, Vol.22(1) : 87, 2021-03 
Journal Title
Issue Date
Chronic obstructive pulmonary disease ; Clinical outcome ; Mortality rate ; Prognosis ; Quality assessment
Background: The 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.

Methods: The 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.

Results: Among 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.

Conclusions: The CQAP by the health insurance bureau has improved the management protocol and prognosis of COPD.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Sung Ryeol(김성렬) ORCID logo https://orcid.org/0000-0001-7418-0049
Park, Jung Won(박중원) ORCID logo https://orcid.org/0000-0003-0249-8749
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
Lee, Jae Hyun(이재현) ORCID logo https://orcid.org/0000-0002-0760-0071
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
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