Koreans’ hospitalization due to chronic diseases and their outpatient antibiotic prescriptions are decreasing but prescriptions for patient safety-related drugs and mental health need to be managed, key findings from OECD Health at a Glance report showed.
On Monday, the Ministry of Health and Welfare released its analysis of Korea's current healthcare quality status based on indicators included in “Health at a Glance 2023,” published by the Organization for Economic Cooperation and Development on Nov. 7.
The ministry analyzed Korea's past, present, and comparative status in seven areas. They are acute care, chronic disease hospitalization rates, outpatient pharmaceutical prescriptions, mental health, patient experience, integrated healthcare, and end-of-life care.
The analysis showed that Korea's healthcare quality level has improved in most indicators of all areas compared to the past. Notably, they showed a steady decline in chronic disease hospitalization rates and total outpatient antibiotic prescriptions.
However, patient safety-related indicators, such as prescription of long-acting benzodiazepines and polypharmacy in patients aged 75 and older, were higher than the OECD average. The quality of mental health was also lower than the OECD average.
In acute care, the 30-day mortality rate for acute myocardial infarction, the leading cause of death in acute care, continued to improve each year at 8.4 percent but was still higher than the OECD average of 7.0 percent. The 30-day mortality rate for ischemic stroke was 3.3 percent, the fourth lowest among OECD countries.
In the chronic disease hospitalization rate, the asthma and chronic obstructive pulmonary disease hospitalization rate of 99.7 per 100,000 people and the congestive heart failure hospitalization rate of 79.1 per 100,000 people were lower than the OECD average. However, the diabetes hospitalization rate of 196.1 per 100,000 people was higher than the OECD average of 102.4.
In the outpatient pharmaceutical prescription, the prescription rate for first-choice antihypertensive drugs for people with diabetes continued to increase to 80.8 percent. Still, it was lower than the OECD average of 84.0 percent.
Total outpatient antibiotic prescriptions averaged 16.0 defined daily doses (DDDs) per 1,000 people, a significant decrease from 23.7 DDDs in 2019, improving to an OECD average of 13.5 DDDs.
Total opioid prescriptions were the second lowest among OECD countries at 1.0 DDD per 1,000 people.
A DDD is a standard unit of measurement for the consumption of medicines, with 1 DDD being the average dose an adult (70 kg) would need to take in a day.
In mental health, the excess mortality ratio for patients with bipolar affective disorder and schizophrenia was 4.2 and 4.6, higher than the OECD average of 2.3 and 3.5. The suicide rate for people with mental illness within one year of discharge was 7.0 percent per 1,000 people, higher than the OECD average of 3.8 percent, indicating the need for continued attention and management.
In the patient experience, 81.4 percent of patients who had received outpatient care reported that their doctor spent enough time with them, compared to the OECD average of 82.2 percent. Also, 88.0 percent reported that their doctor explained things in a way they could understand, slightly lower than the OECD average of 90.6 percent.
In addition, 89.2 percent of patients said they were involved in their care and treatment decisions, compared to the OECD average of 83.6 percent. However, in the patient experience, there may be limitations in interpreting comparative results due to differences in response rates and response cultures across countries, the report said.
Integrated care measures quality, including improved patient outcomes, when patients with chronic conditions receive integrated care from multiple healthcare providers. For example, the mortality rate for ischemic stroke patients within one year of discharge was 14.4 percent, lower than the OECD average of 15.5 percent.
End-of-life care indirectly measures the quality of care in terms of providing appropriate palliative care before death and relieving physical and psychological suffering for patients and their families. By that standard, the percentage of deaths that occurred in a healthcare facility was 69.9 percent, the highest among OECD members, whose average was 49.1 percent.
However, the end-of-life care area is highly influenced by each country's healthcare system and various socio-cultural conditions, so it noted limitations to objectification.
"As the demand for producing new healthcare quality statistics, such as people-centeredness and end-of-life care, is increasing, we will continue to cooperate with various international organizations, including OECD and WHO, to expand the production of related statistics and do our best to help Koreans actively use them in various policy areas, including healthcare," said Kim Sun-do, information and statistics officer at the ministry.