Korea has steadily improved the quality of acute treatment and care for outpatients, compared to other OECD members, but needs better management of long-term multidrug use by outpatients, an OECD report said.

The Ministry of Health and Welfare released the OECD report on Korea’s healthcare quality and outcome as of 2017, as well as those of other member nations of the Organization for Economic Cooperation and Development.

The club of industrialized countries collects and analyzes each member’s key healthcare indexes through its “Healthcare Quality and Outcomes” project. Korea collects statistics of claims for medical expenses from the Health Insurance Review and Assessment Service (HIRA) as the primary data source and submits them to it.

The OECD report indicated that Korea’s quality of acute care and outpatient treatment continued to improve and that the nation provided the best healthcare service for colorectal cancer and gastric cancer among the organization.

Korea also gradually improved the quality of outpatient prescription.

However, the nation should better manage prescriptions of multiple drugs for outpatients who take five or more medications with different ingredients at the same time for 90 days or longer, the OECD said.

Primary care still poor, cancer care at the best level

In terms of the acute myocardial infarction and the 30-day fatality rate caused by stroke, which are representative indicators of the quality of acute care, Korea’s fatality rate among patients over 45 years of age admitted with ischemic stroke in 30 days stood at 3.2 percent in 2017, much lower than the OECD average of 7.7 percent.

The 30-day fatality rate for acute myocardial infarction in Korea has declined since 2008 but started to increase in 2016. The figure went up to 9.6 percent in 2017, higher than the OECD average of 6.9 percent.

The hospitalization rate for asthma and diabetes among chronic diseases that can be preventable if managed well in primary care was 81 and 245.2 per 100,000 people, respectively, higher than the OECD average of 41.9 and 129.

The chronic disease-induced admission rate has slid since 2008, and chronic obstructive lung disease-related hospitalization rate was approaching the OECD average.

Korea recorded a five-year net survival rate for colon cancer, rectal cancer, and gastric cancer at 71.8 percent, 71.1 percent, and 68.9 percent, which were the highest levels among OECD.

Five-year net survival of Korean people with lung cancer was 25.1 percent, higher than the OECD average at 17.2 percent. Net survival for acute lymphocytic leukemia was 84.4 percent in Korea, slightly higher than the OECD average of 83.7 percent.

Korea’s polypharmacy 20% points higher than the OECD average

OECD measures outpatient prescription levels with multidrug prescriptions, opioid prescriptions, antipsychotic prescriptions, antibiotic prescriptions, diabetic prescriptions, and benzodiazepine prescriptions.

In 2017, Korea had 68.1 percent of “polypharmacy,” or prescribing five or more different prescription drugs at once for people aged 75 or more, which was the highest among seven OECD members that submitted related statistics. The average of polypharmacy in the seven nations stood at 48.3 percent.

The prescription of opioids and anti-psychotics was 0.9 defined daily doses (DDD) per 1,000 people in 2017, which was the second-lowest after Turkey.

Korea has low prescriptions of opioids due to strict drug regulation and people’s repulsion of the term “drug.”

The prescription rate of first-line hypertension drugs to reduce the risk of diabetic nephropathy and slow the progression of hyperalbuminemia in diabetic patients with hypertension was 78 percent, lower than the OECD average of 82.9 percent. However, the rate was on the rise.

To prevent cardiovascular disease in diabetic patients, treatment guidelines recommend prescribing lipid-lowering drugs.

In Korea, the prescription of lipid-lowering agents went up by 23.3 percentage points from 44.1 percent in 2011 to 67.4 percent in 2017.

80% satisfied with patient care time

According to the 2018 survey on outpatients about their experience of doctors’ treatment, 80.8 percent said their doctors spent enough time to care for them. Eighty-three percent said doctors explained well to help them understand easily, and 82.4 percent said they have experienced participating in treatment decisions.

In mental health, the excess mortality ratio of schizophrenia was 4.42, and bipolar affective disorder, 4.21, which were higher than the average of 4.0 and 2.9 in all OECD countries.

The excess mortality ratio refers to the rate of the mortality of people with mental illnesses to the mortality of the general population aged between 15 and 74.

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