As medical expenses increase rapidly, countries are facing the challenge of providing valuable services for the cost. It is necessary to evaluate the quality and performance of medical care centering on health outcomes at the system level. This study is to examine the health outcomes of the healthcare quality and system at the national level and to analyze Korea’s medical quality management system.
As the first part, a medical quality report was designed by benchmarking the NHS Outcomes Framework in the UK. Our results show that number of years of potential life loss due to avoidable causes, a general indicator of early death prevention (effectiveness), has been shown to have improved steadily over the past 10 years. The quality of life of people with patients was not significantly improved, and emergency readmission within 30 days of hospital discharge deteriorated recently. In the patient-centered area, inpatient service was not significantly improved. Although Korea's health care system has made considerable results in acute medical services, it shows that it does not play a sufficient role in responding to chronic diseases that are increasing along with an aging population and lifestyle changes.
As the second part, we analyzed medical quality management system. The first problem in the area of ？？effectiveness is the segmentation of the system. Strategic plans are divided into diseases, and there is no comprehensive strategy or plan at the healthcare system level. It shows that the current Korean healthcare system remains ‘disease-centered’, which may lead to the result of the healthcare system focusing on the clinical effectiveness of individual services rather than seeking improvement of health outcomes centering on people. The segmented system is also confirmed in the quality management system for medical institutions. The standard setting function is insufficient. In particular, as the importance of preventing and managing chronic diseases is emphasized, it is necessary to establish a standard for providing evidence-based treatment in the areas of primary and secondary prevention. In addition, quality standards can be effectively used when they are created through cooperation and social consensus between related organizations based on evidence, but this process is insufficient.
The analysis results provide implications for the areas in which Korea's medical system needs innovation. First of all, as a problem that has been continuously mentioned in several studies, it is necessary to move from acute disease treatment center to chronic disease prevention and management. Temporary results can be achieved by individual specialists or procedures, but the results themselves are achieved through comprehensive care for the patient's condition. Chronic diseases are not the quality of individual outputs, especially in that short-term treatment does not achieve health outcomes. An approach is needed in terms of system quality. Next, it is necessary to diagnose and invest in areas where sufficient investment is not being made in terms of system quality. Comprehensive and systematic continuous monitoring is needed to confirm this.
It is necessary to develop strategies at the national level to improve medical quality. How to set standards, monitor and improve quality in each stage of medical service (prevention, treatment, rehabilitation, terminal care) to improve the effectiveness, patient-centeredness, and responsiveness of medical services through the establishment of an integrated national medical quality strategy. Long-term planning is needed. Next, In terms of strengthening the accountability of the medical system, it is necessary to prepare a system-level performance monitoring and reporting system. Reinforcing the accountability of the medical system is to disclose to the public so that the public can understand where the Korean medical system is performing and what is insufficient. National-level health care quality strategies, performance reporting and monitoring should be linked to quality management activities in the health care field. For this, quality standards must be developed consistently in all areas. It acts as a kind of standard library.