Korean J Health Promot.  2020 Dec;20(4):175-181. 10.15384/kjhp.2020.20.4.175.

Changes in Indicators after Assessment of Diabetes Mellitus Adequacy Evaluation: Korean Health Insurance Review and Assessment Service Data 2010-2015

• Kang HS
• Lim MT
• Kim BY
• Han KD
• Lee KM
• Jung SP

• KMID: 2509874
• DOI: http://doi.org/10.15384/kjhp.2020.20.4.175

Abstract

Background
The Korean Health Insurance Review and Assessment Service has conducted diabetes medical adequacy evaluation projects since 2010. This study aimed to evaluate the medical adequacy of type 2 diabetes mellitus patients after the assessment project and help establish the direction of future projects.
Methods
Using data from the Health Insurance Review & Assessment Service (2010-2015), chi-square tests and t-tests were used to analyze the enforcement rate according to a combination of items for appropriate management methods. Logistic regression and linearity test were performed to assess the relationships among the evaluation group, appropriate test items, and prescription rate.
Results
We found that 33.6-39.8% of patients did not undergo any diabetes-related tests. Only about 7% of hemoglobin A1c (HbA1c) tests were performed, and 36% of cases were tested simultaneously with serum lipid profile tests. As age increased, the number of days taken to prescribe diabetes medications also increased. The prescription rate of diabetes drugs for 292 days or more was 61% in patients who had not been tested for adequacy, and the average prescription rate increased as the number of tests increased.
Conclusions
In older adults with a high prevalence of diabetes, it is necessary to establish a test rate for proper management of diabetes, including HbA1c, and related test items to increase the average prescription rate.

Keyword

Diabetes complication; Diabetes mellitus; Drug prescription; Quality assurance

Figure

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  Fig. 1. Flow chart of study participants. DM, diabetes mellitus.

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  Fig. 2. The prescription rate (over 292 days)a and pharmaceutical cost according to appropriate test number. Red line means average pharmaceutical costb and green line means total pharmaceutical cost. aCalculated by trend, P<0.01. bCalculated by linearity test, P<0.05.

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