보건행정학회지 (Health Policy and Management)

  • 제19권3호
  • /
  • Pages.1-26
  • /
  • 2009
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  • 1225-4266(pISSN)
  • /
  • 2289-0149(eISSN)
한국보건행정학회 (Korean Academy of Health Policy and Management)
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의료의 질 평가 우선순위 설정

Priority Areas for National Health Care Quality Evaluation in Korea

  • 신숙연 (건강보험심사평가원) ;
  • 박춘선 (건강보험심사평가원) ;
  • 김선민 (건강보험심사평가원) ;
  • 김남순 (동국대학교 의과대학 예방의학교실) ;
  • 이상일 (울산대학교 의과대학 예방의학교실)
  • Shin, Suk-Youn (Health Insurance Review and Assessment Service) ;
  • Park, Choon-Seon (Health Insurance Review and Assessment Service) ;
  • Kim, Sun-Min (Health Insurance Review and Assessment Service) ;
  • Kim, Nam-Soon (Department of Preventive Medicine, College of medicine, Dongguk University) ;
  • Lee, Sang-Il (Department of Preventive Medicine, College of medicine, University of Ulsan)
  • 발행 : 2009.09.30
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초록

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

키워드

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