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

Abstract

Colorectal cancer (CRC) is increasing in South Korea due to westernized eating habits and regular health checkups. 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.

Pulmonary Metastasectomy in Colorectal Cancer: A Population-Based Retrospective Cohort Study Using the Korean National Health Insurance Database

“…Distal colon cancer accounted for 79.1% of the study population and distal colon cancer was associated with a better survival outcome compared with proximal colon cancer in multivariate analysis. In a recent population-based study, distal colon cancer (left colon and rectum) accounted for 62% of total primary CRC resection cases in Korea [15]. Rectal cancer is more frequently associated with lung metastasis compared to colon cancer [2,16], and the findings of this study supported this relationship.…”

“…Demographic data included sex, age at the time of pulmonary resection, income level, and type of health insurance. The income level was grouped into low (0-8), medium (9)(10)(11)(12)(13)(14)(15)(16), and high (17)(18)(19)(20), using 20-quantile data from the NHIS. The cases of surgery for CRC were categorized to distal (QA921-6) and proximal (QA671-3 and QA679) resection by using the operation code (S1 Table ).…”

Colorectal cancer mortality trends in the era of cancer survivorship in Korea: 2000–2020

“…This trend was also evident in the Korean population and eventually ASMR decreased during the second decade. While the initiation of a nationwide screening program may have a primary role in lowering colorectal cancer ASMR through early detection and treatment of cancerous lesions in their earlier state, there are additional policy-induced contributing factors to the decrease in ASMR over the years including increasing awareness for higher adherence rates of screening [ 3 , 15 ], better treatment options available through insurance coverage [ 16 ], and nationwide quality assessment of the treatment given to colorectal cancer patients [ 17 ]. This has in turn led to a higher standard of care where Korea is now one of the leading countries in terms of colorectal cancer treatment and survival rates [ 18 , 19 ].…”

Multidisciplinary treatment strategy for early rectal cancer

“…Colorectal cancer is one of the most common gastrointestinal cancers in Korea [1]. Rectal cancer has the highest frequency, accounting for almost half of colorectal cancers.…”