TRENDS OF QUALITY OF COPD MANAGEMENT IN KOREA: 3-YEAR FOLLOW-UP OF NATIONAL HEALTH INSURANCE CLAIM DATA

Abstract

SESSION TITLE: Tuesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: In Korea, quality assessment program about COPD management has been launched since 2014 by the Health Insurance Review and Assessment Service. Proportions of patients with prescription of inhaled bronchodilator and performance rate of spirometry are essential indicator to evaluate the quality of COPD management in each healthcare institution in addition to proportion of patient on regular follow-up. In this study, we explored the trends of quality of COPD management using the national health insurance claim database in Korea. METHODS: We analyzed the health insurance claim data of COPD patients who were enrolled in COPD quality assessment program for 3 consecutive years since 2014. We evaluated pattern of prescription of inhalers and performance rate of spirometry for the study period. COPD-related hospitalization was also evaluated. RESULTS: A total of 68,943 patients were included in this study and 80% of them were male. About one fifth of patients experienced COPD-related hospitalization during follow-up (17.5% in 2014, 16.4% in 2015 and 19.1% in 2016). The prescription rates of inhaled bronchodilator were 87.0% in 2014, 86.4% in 2015 and 80.9% in 2016, respectively. Triple therapy (ICS+LABA+LAMA) was the most frequently prescribed inhaler (24.5% in 2014, 24.6% in 2015 and 22.7% in 2016). Combination of ICS and LABA was the second one (20.1% in 2014, 19.6% in 2015 and 20.0% in 2016). The prescription rate of dual bronchodilator (LABA+LAMA) increased from 4.0% in 2014 to 17.1% in 2016. The performance rates of spirometry were 53.6% in 2014, 52.4% in 2015 and 53.9% in 2016, respectively. CONCLUSIONS: In conclusion, from the national data of quality assessment program, we showed that the prescription rate of inhaled bronchodilator was decreasing in patients who were regularly followed for COPD from 2014 to 2016 in Korea. And the performance rate of spirometry was still low. CLINICAL IMPLICATIONS: A new strategy needs to be developed to increase prescription rate of inhaled bronchodilator and performance rate of spirometry to improve quality of COPD management. DISCLOSURES: No relevant relationships by Yong Il Hwang, source=Web Response No relevant relationships by SEUNG HUN JANG, source=Web Response No relevant relationships by Ki-Suck Jung, source=Web Response No relevant relationships by Chang Youl Lee, source=Web Response no disclosure on file for Sunghoon Park; no disclosure on file for Jiyoung Park