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KMID : 1154920210160010001
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Korean Journal of Insurance Medicine
2021 Volume.16 No. 1 p.1 ~ p.11
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Choi Kyu-Hye
Lee Sea-Won
Lee Jong-Hoon
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Abstract
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Background: The incidence of breast cancer in Korea is increasing due to changes in culture and dietary habit. The Korean Health Insurance Review and Assessment Service (HIRA) has been conducting national quality assessments of the treatment of breast cancer to reduce variations in social costs and improve oncologic outcomes. This study aimed to evaluate the trends of the results of the quality assessments for 5 years from 2013 to 2017, and suggest future directions for improving the quality of treatment in accordance with the epidemiologic changes.
Methods: Evaluation of medical institutions where breast cancer surgery patients was conducted based on Korean healthcare claims database and medical records. A total of 20 indicators for evaluation were used. The coefficient of variation was calculated to identify the variation between institutions, and then the trend of the coefficient of variation by year was analyzed.
Results: In structural and process indicators, 8 out of 18 factors showed a difference between institutions with a coefficient of variation greater than 0.1% at the time of initial evaluation. In the five-year trend since then, the coefficient of variability decreased in 6 indicators, but the coefficient of variability was still higher than 0.1% in the 4 indicators (professional staff composition, target therapy execution rate, average hospitalization days and cost).
Conclusion: The difference of breast cancer treatment according to the type of institution was generally improving, but it was found that the difference in the composition of the medical staff and adjuvant therapy execution was still not resolved. It is necessary to modify indicators in the structure or process and to revise the evaluation method.
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KEYWORD
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Breast cancer, Quality assurance, Korean, Trend
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