Indicators and Qualitative Assessment of Lung Cancer Management by Health Insurance Review and Assessment Service (HIRA) of Korea in 2015

Abstract

Cancer is the leading cause of death in the Republic of Korea and cancer death accounts for 27.8% of the total deaths, which is not only a social issue but also a concern for the public. Among the cancer death rates, lung cancer mortality account for 34 deaths per 100,000 populations, making it the number one cancer death rate. In a preliminary report on cancer death in 2012, the lung cancer mortality ratio showed the regional variation indicating that there were differences in the qualitative level and the structure among the medical care benefit agency and in the assessment of the treatment process. Therefore, the Health Insurance Review and Assessment Service (HIRA) had begun evaluation of the assessment of lung cancer treatment since 2014 to improve the quality of lung cancer care through evaluation and feeds back the results of lung cancer care process. In this report, authors described the current Indicators for the lung cancer adequacy assessment proposed by HIRA and results of the evaluation reported in 2017.

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

“…Our study had several strengths. There were previously only reviews of reports published by the HIRA regarding qualitative assessments 18,51,52 , but we actively evaluated the effectiveness of the asthma management and the policy through quantitative analysis using raw data from health insurance claims. Also, this quantitative statistical analysis applied a clustering algorithm to analyze the asthma severity pattern in large cohort data.…”

Prevalence and analysis of tobacco use disorder in patients diagnosed with lung cancer

“…It is well known that chronic smoking induces neuroadaptation, which interferes with behavioral changes [26]. Accordingly, it is essential to tailor TUD intervention for current smokers with lung cancer [27, 28]. For example, according to Chun, the combination of counseling and pharmacotherapy in patients with chronic obstructive pulmonary disease (COPD) increased the quitting rate more than twice than behavioral intervention alone.…”

Recent advances in diagnostic technologies in lung cancer

“…As the survival of lung cancer patients increases, improvement of drug permeability of the bloodbrain barrier has become an important consideration for pharmaceutical companies when developing anti-cancer drugs. HIRA guidelines recommend assessment of brain metastases for initial staging and preoperative evaluation of lung cancer [5]. However, with the recent increase in the early diagnosis of lung cancer, the need for brain magnetic resonance imaging (MRI) for staging tumors less than 2 cm in size has been questioned [12].…”

“…It also has a high false positive rate due to trauma, inflammation and degenerative change of skeletal system and thus, the routine use of WBBS is not recommended by the National Comprehensive Cancer Network guidelines [13]. Moreover, implementation of WBBS for lung cancer is on the decline in Korea as the HIRA indicator does not include bone scans as imaging tools conducted for lung cancer bone metastasis [5]. www.kjim.org https://doi.org/10.3904/kjim.2020.030…”

“…These findings imply that majority of lung cancer patients are diagnosed at advanced stages which cannot be cured by surgery or other therapeutic modalities, but also indicate that there are great demands for improvement in the diagnosis and treatment. Recently, to standardize the diagnosis and treatment of lung cancer, the Korean Health Insurance Review and Assessment (HIRA) has developed indicators, applied evaluation guidelines and reported the results [5]. Moreover, in July 2019, Korean national lung cancer screening projects using lowdose chest computed tomography (CT) were launched for groups at high-risk for lung cancer.…”