Tuberc Respir Dis.  2018 Jul;81(3):175-186. 10.4046/trd.2017.0093.

Evaluation of the Quality of Care among Hospitalized Adult Patients with Community-Acquired Pneumonia in Korea

• Hong JY
• Kang YA

• KMID: 2414560
• DOI: http://doi.org/10.4046/trd.2017.0093

Abstract

Pneumonia is an important cause of morbidity and mortality. Since 2014, the Health Insurance Review and Assessment Service (HIRA) has assessed the overall quality of care among hospitalized adult patients with community-acquired pneumonia (CAP) provided by all medical institutions in Korea. A committee of the Korea Academy of Tuberculosis and Respiratory Diseases developed the hospital inpatient quality measures set for CAP consisting of eight core measures and five monitoring measures. The composite measure score was calculated. The medical records of hospitalized adult patients ages 18 years or more with CAP from October to December 2014 were evaluated. The data of 523 hospitals (42 tertiary hospitals [8.0%], 256 general hospitals [49%], and 225 hospitals [43.0%]) and 15,432 cases (tertiary hospitals, 1,673 cases [10.8%]; general hospitals, 8,803 cases [57.1%]; hospitals, 4,956 cases [32.1%]) were analyzed. We found large variations among institutions in terms of performance of care measures for CAP. For the composite measure score, the mean value was 66.7 (tertiary hospitals, 98.5; general hospitals, 79.2; hospitals, 43.8). Despite significant differences in measure scores between tertiary, general hospitals and hospitals, no significant differences were found in mortality between hospitals. Further studies are needed to determine the care measures appropriate for CAP.

Keyword

Quality of Care; Pneumonia; Quality Improvement

MeSH Terms

Adult*
Hospitals, General
Humans
Inpatients
Insurance, Health
Korea*
Medical Records
Mortality
Pneumonia*
Quality Improvement
Tertiary Care Centers
Tuberculosis

Figure

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  Figure 1 Performance rates of oxygenation assessment according to institution.

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  Figure 2 Performance rates of pneumonia severity assessment according to institution.

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  Figure 3 Performance rates of sputum smears within 24 hours of hospital arrival according to institution.

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  Figure 4 The performance rates of sputum cultures performed within 24 hours of hospital arrival according to institution.

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  Figure 5 Performance rates of blood cultures taken prior to the initial administration of antibiotics according to institution.

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  Figure 6 Performance rates of the administration of the first dose of antibiotics within 8 hours of the time of hospital arrival according to institution.

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  Figure 7 Performance rates of smoking cessation counseling according to institution.

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  Figure 8 Performance rates of screening for pneumococcal vaccination according to institution.

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  Figure 9 Distribution of composite measure scores.

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