A Decade of Healthcare Quality Assessment for Chronic Obstructive Pulmonary Disease in South Korea: Trends and Implications (2014-2023).

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder associated with substantial morbidity and healthcare costs. Effective outpatient management can prevent exacerbations and reduce hospitalization rates. Since 2014, the South Korean government has conducted annual COPD quality assessment to improve disease management and ensure high-quality healthcare services. The results of the 9th COPD quality assessment, conducted between January and December 2023, were recently published.

Methods: Healthcare institutions providing outpatient services for COPD (ICD-10 codes J43, J44 except J43.0) were evaluated based on pulmonary function test (PFT) rates, rate of continuous outpatient visits, and inhaled bronchodilator prescription rates. The monitoring indices included COPD-related hospitalization, emergency room (ER) visits, and duration of inhaled bronchodilator prescriptions.

Results: A total of 6,339 institutions and 158,906 patients were assessed in 2023. The PFT rate increased from 58.7% in 2014 to 80.3% in 2023, with the highest rates observed in tertiary hospitals (92.0%) and the lowest in clinics (53.6%). The inhaled bronchodilator prescription rate reached 91.5%, demonstrating a continuous improvement in pharmacological therapy. However, the rate of continuous outpatient visits declined to 80.2%, and COPD-related hospitalization (10.8%) and ER visits (6.4%) increased, indicating persistent gaps in outpatient management.

Conclusion: The COPD quality assessment program has significantly improved diagnostic and pharmacological management; however, it highlights ongoing challenges in rate of continuous outpatient visits. Addressing regional disparities, strengthening primary care, and increasing public awareness are essential for the optimization of COPD management. Future efforts should focus on enhancing the implementation of PFTs and ensuring adequate reimbursement for inhaler education.