Comparison of clinical characteristics and management of asthma by types of health care in South Korea

Abstract

Most patients with asthma were treated via primary care; however, those receiving secondary or tertiary care exhibited substantial utilization of medical facilities with high costs. Diagnostic measures and the prescription of inhalants containing corticosteroids in primary care require urgent attention.

Increased mortality in patients with corticosteroid-dependent asthma: a nationwide population-based study

“…In real-world contexts, nonadherence regarding ICS use is an important problem in elderly patients [35]. Second, low prescription rates of ICS have been documented in real-world practice, especially in primary clinics in Korea [22][23][24]. Third, some physicians may believe that ICS is not necessary when a patient receives systemic CS, which is more potent than ICS.…”

“…Since data associated with ED visits and hospitalisations are also included as claims data in the NHIS database, the definition of chronic asthma used in this study is very similar to that recognised by HEDIS criteria. In addition, we used the same definition that was used in several previous studies evaluating asthma in Korea using the NHIS database [22][23][24]. Thus, despite some limitations, the definition of asthma used in this study is acceptable in the current situation, as an internationally accepted definition of chronic asthma is not available.…”

“…The follow-up period was from the index date to the date of death or December 31, 2015, whichever was sooner (supplementary figure E2). Asthma in adults was defined according to the following criteria: 1) age ⩾18 years, 2) at least two claims under ICD-10 codes J45-J46, and 3) at least one claim in the baseline period for prescription of asthma-related drugs such as inhaled CS (ICS) or systemic CS, bronchodilators, leukotriene receptor antagonists and xanthine derivatives [22][23][24]. CS-dependent asthma was defined as: 1) presence of asthma and 2) prescription of systemic CS under ICD-10 codes J45-J46 for ⩾6 months in the baseline period [8,13,25].…”

Coexisting Respiratory Comorbidities Increase Mortality in Patients with Asthma: A National Cohort Study

“…Adult asthma was defined based on the following criteria: (1) 18 years of age or older, (2) at least two claims under the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes J45-46, and (3) at least one claim for prescription of asthma-related drugs including inhaled or systemic corticosteroids, bronchodilators, leukotriene receptor antagonists, or xanthine derivatives 12,13 . The index event for incident asthma was defined as the first prescription of asthma-related medication with ICD codes J45-46 as a major or minor diagnosis between January 1, 2005, and December 31, 2006, with no diagnosis code more than three years before the first index event after the sensitivity test.…”

The nationwide retrospective cohort study by Health Insurance Review and Assessment Service proves that asthma management decreases the exacerbation risk of asthma

“…Asthma management in tertiary hospitals was assumed to be the best among medical institutions, as they had sufficient personnel, facilities, and equipment as prescribed by the ordinance of the Ministry of Health and Welfare. To date, studies on the HIRA assessments have only examined simple descriptive statistics, for example, comparisons of the types of prescribed medications for each stage dependent on the medical institution or comparisons of the pulmonary function test (PFT) ratios 17,18 . In this study, intervention implementation in quality assessment could be tested while collecting evidence of clinical effectiveness that improved asthma management; such a study would be considered a type 3 hybrid design, i.e.…”