Hye Jung Park1, Sung-Ryeol Kim2, Sinae Kim3, Hye Sun Lee4, Bo Yeon Kim5, Hye Kyoung Kim5, Sang In Ahn5, Ji Hyeon Shin5, Jae-Hyun Lee6, Jung-Won Park2. 1. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. 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. 3. Data Analysis Team, Social Security Information Service, Yonsei University College of Medicine, Seoul, Republic of Korea. 4. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea. 5. Healthcare Insurance Review and Assessment Service, Wonju, Republic of Korea. 6. 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. Electronic address: jhleemd@yuhs.ac.
Abstract
BACKGROUND: In 2013, the Korean Health Insurance Review and Assessment Service launched the Asthma Quality Assessment Program (AQAP) to assess whether patients with asthma were well managed. OBJECTIVE: To show the impact of the AQAP on the medical utilization behavior for asthma. METHODS: We used claims data linked with the results of the AQAP performed between July 2013 and June 2017. Asthma was determined when subjects visited hospital for asthma. Subjects who used asthma medications on at least 2 different occasions were assessed by the AQAP (assessed subjects [Ass]; not-assessed subjects [NASs]). The AQAP evaluated conduction rate of the pulmonary function test, routine visit rate, and prescription rate of asthma medications. Primary clinics were classified as "good" and "not-good" clinics according to the results of the AQAP. RESULTS: Of the 4.3 million subjects with asthma screened, about 0.8 million were assessed by the AQAP annually. Both the conduction rate of pulmonary function test and the prescription rate of inhaled corticosteroids in the ASs and NASs were improved. In addition, the risk of admission and yearly all-cause mortality were significantly reduced (risk reduction rate, 17.1 and 24.4%, respectively, both P < .001) in the AS group compared with the NAS group. However, effects of the AQAP varied according to the subgroup, and they were restricted to the assessment term. In addition, the admission rate and all-cause mortality were decreased by 94.7% and 45.3%, respectively, in "good" clinics as opposed to the "not-good" clinics. CONCLUSIONS: Performing the AQAP improved both the management protocol and prognosis of asthma in Korea.
BACKGROUND: In 2013, the Korean Health Insurance Review and Assessment Service launched the Asthma Quality Assessment Program (AQAP) to assess whether patients with asthma were well managed. OBJECTIVE: To show the impact of the AQAP on the medical utilization behavior for asthma. METHODS: We used claims data linked with the results of the AQAP performed between July 2013 and June 2017. Asthma was determined when subjects visited hospital for asthma. Subjects who used asthma medications on at least 2 different occasions were assessed by the AQAP (assessed subjects [Ass]; not-assessed subjects [NASs]). The AQAP evaluated conduction rate of the pulmonary function test, routine visit rate, and prescription rate of asthma medications. Primary clinics were classified as "good" and "not-good" clinics according to the results of the AQAP. RESULTS: Of the 4.3 million subjects with asthma screened, about 0.8 million were assessed by the AQAP annually. Both the conduction rate of pulmonary function test and the prescription rate of inhaled corticosteroids in the ASs and NASs were improved. In addition, the risk of admission and yearly all-cause mortality were significantly reduced (risk reduction rate, 17.1 and 24.4%, respectively, both P < .001) in the AS group compared with the NAS group. However, effects of the AQAP varied according to the subgroup, and they were restricted to the assessment term. In addition, the admission rate and all-cause mortality were decreased by 94.7% and 45.3%, respectively, in "good" clinics as opposed to the "not-good" clinics. CONCLUSIONS: Performing the AQAP improved both the management protocol and prognosis of asthma in Korea.