Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea.
Department of Medical Consilience, Graduate School of Dankook University, Jukjeon, Korea.
Sci Rep. 2021 Jan 14;11(1):1442. doi: 10.1038/s41598-021-81022-z.
Medical costs have recently increased in South Korea due to the rising rate of asthma. Primary clinics serve an important role in asthma management, as they are the first stop for patients presenting with symptoms. The Health Insurance Review and Assessment Service (HIRA) in South Korea has assessed asthma-management quality since 2013, but studies are lacking on whether these assessments have been performed properly and contribute toward reducing asthma exacerbations. Therefore, we investigated whether the HIRA's quality assessments have decreased asthma exacerbations using national health insurance claims data from 2013 to 2017 of 83,375 primary-clinic and 15,931 tertiary-hospital patients with asthma. These patients were classified into four groups based on disease severity according to the monthly prescribed amount of asthma medication using K-means clustering. The associations between HIRA assessments and asthma exacerbation were analyzed using a generalized estimating equation. Our results showed that exacerbation odds gradually decreased as the HIRA assessments progressed, especially in the mild-severity group, and that exacerbation risk among patients with asthma decreased in the order of assessment grades: "Unsatisfactory," "Satisfactory," and "Tertiary." Therefore, we may conclude that asthma exacerbations may decrease with high quality asthma management; appropriate quality assessment could be helpful in reducing asthma exacerbations.
由于哮喘发病率的上升,韩国最近的医疗费用有所增加。初级诊所在哮喘管理中起着重要作用,因为它们是出现症状的患者的第一站。韩国的医疗保险审查和评估服务(HIRA)自 2013 年以来一直在评估哮喘管理质量,但缺乏这些评估是否得到正确执行以及是否有助于减少哮喘恶化的研究。因此,我们使用 2013 年至 2017 年全国健康保险索赔数据,对 83375 名初级诊所和 15931 名三级医院哮喘患者进行了研究,调查 HIRA 的质量评估是否通过降低哮喘恶化率来实现。这些患者根据哮喘药物每月处方量,使用 K-均值聚类法分为四个疾病严重程度组。使用广义估计方程分析 HIRA 评估与哮喘恶化之间的关联。结果表明,随着 HIRA 评估的进展,恶化的几率逐渐降低,尤其是在轻度严重程度组,哮喘患者的恶化风险按评估等级的顺序降低:“不满意”、“满意”和“三级”。因此,我们可以得出结论,通过高质量的哮喘管理可以降低哮喘恶化率;适当的质量评估可能有助于减少哮喘恶化。