Hyun-Soo Kang,Min-Taek Lim1, Bo-Yeon Kim2, Kyong-Do Han3, Keun-Mi Lee1, Seung-Pil Jung

1Department of Family Medicine, Yeung-Nam University Medical Center, Yeung-Nam University College of Medicine, Daegu, Korea 2Department of Healthcare Review, Health Insurance Review & Assessment Service, Wonju, Korea 3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea

Changes in Indicators after Assessment of Diabetes Mellitus Adequacy Evaluation: Korean Health Insurance Review and Assessment Service Data 2010-2015 Hyun-Soo Kang1, Min-Taek Lim1, Bo-Yeon Kim2, Kyong-Do Han3, Keun-Mi Lee1, Seung-Pil Jung1 1Department of Family Medicine, Yeung-Nam University Medical Center, Yeung- Nam University College of Medicine, Daegu, Korea 2Department of Healthcare Review, Health Insurance Review & Assessment Service, Wonju, Korea 3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
Background: The Korean Health Insurance Review and Assessment Service has conducted diabetes medical adequacy evaluation projects since 2010. This study aimed to evaluate the medical adequacy of type 2 dia- betes mellitus patients after the assessment project and help establish the direction of future projects.
Methods: Using data from the Health Insurance Review & Assessment Service (2010-2015), chi-square tests and t-tests were used to analyze the enforcement rate according to a combination of items for appropriate man- agement methods. Logistic regression and linearity test were performed to assess the relationships among the evaluation group, appropriate test items, and prescription rate.
Results: We found that 33.6-39.8% of patients did not undergo any diabetes-related tests. Only about 7% of he- moglobin A1c (HbA1c) tests were performed, and 36% of cases were tested simultaneously with serum lipid profile tests. As age increased, the number of days taken to prescribe diabetes medications also increased. The prescription rate of diabetes drugs for 292 days or more was 61% in patients who had not been tested for adequacy, and the average prescription rate increased as the number of tests increased.
Conclusions: In older adults with a high prevalence of diabetes, it is necessary to establish a test rate for proper management of diabetes, including HbA1c, and related test items to increase the average prescription rate.
Korean J Health Promot 2020;20(4):175-181