Published online: September 1, 2020
Asthma is a chronic airway disease requiring steady monitoring, appropriate medication, and continuous management. In 2013, the Korean Health Insurance Review and Assessment Service (HIRA) launched the National Asthma Quality Assessment Program (AQAP) to improve patient management protocols and the clinical outcomes of patients with asthma. This program is conducted annually to assess management protocols of patients with asthma. In addition, the AQAP scored the results of the assessment and released the results to the public through its website. However, little is known about the real effects of this national program on asthma care and outcomes.
In this study published by Park et al. in The Journal of Allergy and Clinical Immunology: In Practice, researchers investigated whether this national program impacted the burden of asthma. They used claims data linked with the results of the AQAP performed between July 2013 and June 2017. Asthma was determined when subjects visited the hospital for asthma treatment. Among them, subjects who used asthma medications on at least 2 different occasions were assessed by the AQAP, and they were referred to as assessed subjects (AS). Others were referred to as not-assessed subjects (NAS). The AQAP evaluated conduction rate of pulmonary function tests (PFTs), routine visit rate, and prescription rate of asthma medications. Primary clinics were classified as "good" and "not-good" clinics according to the results of the AQAP.
Of the 4.3 million Korean subjects with asthma screened, about 0.8 million were assessed by the AQAP annually. Both the conduction rate of PFTs and the prescription rate of inhaled corticosteroids in the AS and NAS were improved after the launch of this national program. However, the risk of admission and yearly all-cause mortality were significantly reduced in the AS compared with NAS. The effects of the AQAP varied according to the subgroup, and they were restricted to the assessment term. Of note, the admission rate and all-cause mortality decreased by 94.7% and 45.3%, respectively, in "good" clinics as opposed to the "not-good" clinics. This study implies that performing the national program, AQAP, conducted by the Korean government, improved both the management protocol and prognosis of asthma in Korea. Therefore, the researchers suggested that the continued application of this national program will be helpful to improve clinical outcomes in asthma patients.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.