Cancer Res Treat.  2021 Apr;53(2):487-496. 10.4143/crt.2020.623.

Current Trends in the Quality Assessment of Colorectal Cancer Practice and Treatment in South Korea during 2012-2017

• Choi KH
• Song JH
• Jang HS
• Kim SH
• Lee JH

• KMID: 2514930
• DOI: http://doi.org/10.4143/crt.2020.623

Abstract

Purpose
Colorectal cancer (CRC) is increasing in South Korea due to westernized eating habits and regular health check-ups. The Korean Health Insurance Review and Assessment Service (HIRA) has conducted a national quality assessment of the treatment of CRC. This study examined the quality assessment report of the Korean HIRA and analyzed the status of practice pattern and the epidemiology of CRC in South Korea.
Materials and Methods
The number of subjects was determined based on the number of surgical procedures in each institution during 2012-2017. The institution types were classified according to the number of beds and the composition of oncologic specialists. Twenty-one indicators for diagnosis, chemotherapy, radiotherapy, surgery, pathology, and mortality were analyzed and the interinstitutional variation for each indicator was calculated.
Results
Among 21 evaluation indices, indicators related to medical records, receipt of chemotherapy with a high coefficient of variation of ≥ 0.1% were improved over 6 years until the survey in 2017. In the analysis of indices affecting surgical mortality, the regional lymph node resection and examination rate (p=0.022) showed a negative correlation with surgical mortality. Hospitalization stay (p < 0.001) and hospitalization cost (p=0.002) were positively correlated with surgical mortality.
Conclusion
This study showed that the treatment quality and examination status for CRC in South Korea were appropriate for improving relevant medical records, receipt of chemotherapy, maintaining the quality of treatment, and mortality. These analyses could be the basis for developing an improved quality assessment program worldwide.

Keyword

Colorectal neoplasms; Quality assessment; Mortality

Figure

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  Fig. 1 Definition of 21 evaluation indices.

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  Fig. 2 Quality assessment process.

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  Fig. 3 Trends in the coefficient of variation for each indicator. (A) Composition and pretreatment evaluation. Surgery-related (B), chemotherapy-related (C), radiotherapy-related (D), and outcome (E) indices. CEA, carcinoembryonic antigen.

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  Fig. 4 Graph of the linear regression analysis for surgical mortality. (A) Regional lymph node dissection. (B) Hospitalization stay. (C) Hospitalization cost.

Reference

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