The results of the 2023 (Cycle 2, Round 1) hemodialysis appropriateness assessment showed that out of a total of 972 institutions, 110 (11.3%) were rated as Grade 1. The overall average score was 82.4 points, with the largest number of institutions (316/37.1%) falling into Grade 2.
The Health Insurance Review and Assessment Service (HIRA) released the results of the "2023 (Cycle 2, Round 1) Hemodialysis Appropriateness Assessment" on the HIRA website and mobile app on the 20th.
This assessment was conducted on medical institutions of clinic level or higher that had hemodialysis claims (January to June 2023) as of January 1, 2023, and that possess hemodialysis machines.
Hemodialysis is one of the renal replacement therapies (hemodialysis, peritoneal dialysis, kidney transplantation) for patients with end-stage renal failure. The number of patients is steadily increasing due to the aging population and the rise in chronic diseases. The number of patients eligible for hemodialysis assessment in 2023 increased by 146.4% compared to 2009.
The number of hemodialysis patients increased by a total of 25,944, from 17,720 in 2009 to 43,664 (146.4%) in 2023.
HIRA has been conducting appropriateness assessments since 2009 (Cycle 1, Round 1) to ensure that hemodialysis patients and their families can safely use medical services. In this assessment, the criteria were reorganized to strengthen quality management by improving evaluation indicators that had reached a certain level.
Still a 'Gap' with 95.8 Points for Tertiary Hospitals and 82.0 Points for Clinics
The assessment results showed that the average overall score was 82.4 points, similar to the previous round. The scores were 95.8 points for tertiary hospitals, 85.6 points for general hospitals, and 82.0 points for clinics.
The evaluation grades were divided into 1 to 5 grades for easy understanding by the public according to the overall score. Among the 972 institutions that calculated the evaluation grade, 110 (11.3%) were Grade 1, and 361 (37.1%) were Grade 2, which had the highest share among the grades.
Looking at the Grade 1 institutions by region, they were relatively evenly distributed across the country, with 35 in the Seoul area, 32 in the Gyeongin area, and 21 in the Gyeongsang area.
Trend of Overall Improvement in Evaluation Indicator Areas
The evaluation indicators are divided into the structure area, which checks the infrastructure such as manpower and facilities to provide appropriate medical services, the process area, which examines the activities of medical staff during the medical service provision process, and the result area, which is related to the results of medical service provision.
Although some indicators were improved in this evaluation, making direct comparison with the previous round difficult, most indicators showed improvement or high levels of results.
Jeon Mi-joo, head of the Evaluation Operation Department, said, "The overall improvement in the results of the hemodialysis appropriateness assessment after reorganizing the evaluation criteria to strengthen the quality management of medical services is the result of continuous efforts by medical institutions to improve quality."
"In the next evaluation, we will strive to eliminate blind spots in patient safety by promoting related research to disclose the results of the hemodialysis appropriateness assessment including the inpatient area as well as the outpatient area," he added.
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