5 or more medications were taken by 68% for older people

MOHW analyzes the results of the OECD 'National Health Care Quality indicators’

Narcotic prescription's rate is lowest level, 81% of patients answered “consultation hours" Enough

Korean proportion of 75 years and over who are taking more than 5 medications concurrently exceeded 68%.

 

It is far exceeding the average of 48% of OECD –member countries.

 

Diabetic prescription rate of first choice antihypertensive medication patientsis 78%, which is lower than the average of 83% in OECD-member countries, but is steadily increasing.

 

In particular, more than eight out of 10 patients said they had enough consulation hours.

 

MOHW(Ministry of Health and Welfare) announced on Nov 17th analyzing the level and status of Korea and each country based on the 2017 results of health care presented by the OECD.

 

In Korea, ▲ the quality of acute care and outpatient care is continuously improving.

 

▲ In particular, the level of colorectal cancer and gastric cancer is the highest level among OECD countries.

 

▲ The level of outpatient prescription is gradually improved, but management by the multi combination prescriptions is required.

 

The multi combination prescriptions means administration of five or more drugs with different ingredients for more than 90 days.

 

Acute myocardial infarction and stroke 30 days mortality after admission to hospital

◆Acute care= Acute myocardial infarction and stroke 30 days mortality rate are representative indicators of the quality of the acute care area.

 

within 30 days of acute stage patients over 45 years of age.

 

The 30-day mortality rate for patients hospitalized for ischemic stroke (over 45 years) in 2017 was 3.2%, the superior level among OECD countries.

 

The OECD average is 7.7%.

 

The 30-day mortality rate for acute myocardial infarction has declined since 2008, but has increased since 2016, with 9.6% in 2017, higher than the OECD average.

 

The OECD average is 6.9%.

 

Cancer five year net survival

◆Chronic disease = Among the chronic diseases that are managed well in primary care areas, hospitalization rates for asthma and diabetes were 81 patients per 100,000 people and 245.2 patients per 100,000 people, respectively, higher than the OECD average.

 

The OECD average is 41.9 patients per 100,000 people for asthma and 129 patients for diabetes.

 

Chronic disease admission rates have only declined since 2008, and COPD disease admission rates are approaching the OECD average ◆Cancer care = The five-year net survival rate in Korea is the highest level of cancer care, with colorectal cancer of 71.8%, rectal cancer of 71.1% and gastric cancer of 68.9% Five-year net survival means the cumulative probability that a cancer patient will survive five years after diagnosis if cancer is the only cause of death.

 

The 5-year net survival rate of lung cancer patients (25.1%) was higher than that of OECD countries (17.2%), and acute lymphocytic leukemia was 84.4%, slightly higher than the OECD average (83.7%).

 

◆ Outpatient prescription = Outpatient prescription level is determined by ▲ multidrug prescription ▲ opioid prescription ▲ antipsychotic prescription ▲ antibiotic prescription rate ▲ diabetes patient prescription ▲ benzodiazepines prescription.

 

Data on multidrug, opioid and antipsychotic prescriptions were first collected this year.

 

First, a multi-drug Prescription is defined as the proportion of patients 75 years of age or older who are chronically taking five or more drugs.

 

In 2017, Korea accounted for 68.1%, the highest among the seven countries that submitted statistics (average: 48.3%).

 

The total prescription for opioids, a narcotic analgesic, was 0.9DDD / 1000 people per day, the lowest next to Turkey.

 

In Korea, narcotics prescriptions are low due to strict narcotics regulation and control , and repulsion from the term of “narcotics”.

 

Defined Daily Dose (DDD) is the average dose that must be taken throughout the day for the main ingredients of the drug to take effect.

 

The prescription rate for antipsychotics for patients 65 years of age and older is 36.2 per 1000 prescription populations, which is among the lowest in the 16 countries where statistics were submitted.

 

Hospital admission rate

In 2017, the amount of antibiotics for outpatient’s prescriptions in Korea was 26.5DDD / 1000 persons / day Medication prescription adequacy in diabetics is measured by first-choice antihypertensive * and hypolipidemic ** prescription rates.

 

Primary antihypertensive agents are drugs used in the initial treatment of hypertension and include diuretics, beta blockers and alpha beta blockers, calcium antagonists, angiotensin converting enzyme inhibitors (ACE inhibitors), and angiotensin receptor blockers (ARBs).

 

Lipid lowering agents are drugs that control blood lipids, such as cholesterol.

 

For diabetics, higher prescription rates produce better results.

 

Prescription rate to reduce the risk of diabetic nephropathy and to slow the progression of hyperalbuminemia in patients with diabetes with high blood pressure is 78%, which is lower than the OECD average (82.9%), but is increasing.

 

In order to prevent cardiovascular disease in diabetic patients, the medical guidelines * recommend prescribing lipid-lowering drugs.In Korea, the level of drug prescription ** in diabetics increased by 23.3% p from 44.1% in 2011 to 67.4% in 2017.

 

Hypnotic benzodiazepines are drugs that require caution due to the increased risk of side effects such as cognitive impairment and falls when taken over 65 years.

 

The long-term prescribing of benzodiazepines was 10.1 patients per 1000 population over the age of 65, lower than the OECD average (33.9).

 

Among the benzodiazepines, long-acting drugs were prescribed for 146.3 patients per 1000 people over the age of 65, more than the OECD average of 52 (52), but significantly lower than in 2011 (241.5).

 

Long-term action of benzodiazepine drugs is expected to have a longer half-life when taken by the elderly, resulting in negative effects due to excessive sedation.

 

Prescribing in primary care related patient safety

Prescription and mental health related to patient safety = 80.8% of patients reported that their doctors had enough time to check out their consultation based on the 2018 medical service experience survey.

 

In addition, 82.9% and 82.4% of the respondents explained that the doctor explained it in an easy-to-understand manner and participated in the decision-making process.

 

The excess mortality rate for schizophrenia was 4.42 and 4.21 for bipolar affective disorder, higher than the OECD average (4, 2.9, respectively).