백내장 수술의 질 관리정책이 비급여렌즈 사용에 미친 영향 분석 (Analysis of the Impact of Quality Management Policies for Cataract Surgery on the Use of Non-covered Lenses)

서지정보

· 발행기관 : 한국보건행정학회
· 수록지 정보 : 보건행정학회지 / 35권 / 2호 / 198 ~ 204페이지
· 저자명 : 박재일, 원영주, 박명배, 장한솔, 이광수

초록

Background: This study evaluates the impact of the partially revised [Disease Group] Notice (No. 2022-293), implemented in 2023, on reducing the use of non-covered lenses during cataract surgeries in South Korea. It aims to empirically assess the effects of the amendments on noncovered lens utilization. Methods: Using claim data for cataract surgeries (N=2,679,307) submitted to the Health Insurance Review and Assessment Service from 2020 to March 2024, this study examined changes in the use of non-covered lenses (dependent variable) associated with the implementation of the revised [Disease Group] Notice (No. 2022-293) (independent variable). Non-covered lens use was identified using the detail code “MT060”. Logistic regression analysis was conducted, adjusting for gender, age, region, and healthcare institution type. Results: Non-covered lens usage significantly declined following the implementation of the revised notice (odds ratio, 0.78; 95% confidence interval, 0.78–0.79; p<0.001). Utilization rates were higher among women and younger patients, while residents of metropolitan areas showed greater usage compared to those in non-metropolitan regions. Clinics reported higher usage rates than hospitals and general hospitals. Conclusion: This study demonstrated that the revised notice contributed to reducing the use of non-covered lenses in cataract surgeries and improving the appropriateness of healthcare services. These findings suggest the effectiveness of policy interventions in managing healthcare resources, including the mitigation of unnecessary medical procedures. Therefore, future studies should more precisely assess the long-term trends before and after the policy implementation to thoroughly evaluate its overall effects.

영어초록

Background: This study evaluates the impact of the partially revised [Disease Group] Notice (No. 2022-293), implemented in 2023, on reducing the use of non-covered lenses during cataract surgeries in South Korea. It aims to empirically assess the effects of the amendments on noncovered lens utilization. Methods: Using claim data for cataract surgeries (N=2,679,307) submitted to the Health Insurance Review and Assessment Service from 2020 to March 2024, this study examined changes in the use of non-covered lenses (dependent variable) associated with the implementation of the revised [Disease Group] Notice (No. 2022-293) (independent variable). Non-covered lens use was identified using the detail code “MT060”. Logistic regression analysis was conducted, adjusting for gender, age, region, and healthcare institution type. Results: Non-covered lens usage significantly declined following the implementation of the revised notice (odds ratio, 0.78; 95% confidence interval, 0.78–0.79; p<0.001). Utilization rates were higher among women and younger patients, while residents of metropolitan areas showed greater usage compared to those in non-metropolitan regions. Clinics reported higher usage rates than hospitals and general hospitals. Conclusion: This study demonstrated that the revised notice contributed to reducing the use of non-covered lenses in cataract surgeries and improving the appropriateness of healthcare services. These findings suggest the effectiveness of policy interventions in managing healthcare resources, including the mitigation of unnecessary medical procedures. Therefore, future studies should more precisely assess the long-term trends before and after the policy implementation to thoroughly evaluate its overall effects.

참고자료

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