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The rate of prescription of total inhaled bronchodilator was 74.9% in case of medical facilities having PFT equipment and 24.46% not having PFT equipment, and the prescription rate showed a large variation (50.44%). Especially, in the case of private clinics, the clinics which own PFT equipment did PFT in 51.25% of the patients and on the contrary the clinics which do not own PFT equipment did PFT in only 21.62% of the patients. The total execution rate of PFT for the medical facilities which own PFT equipment was 67.41% and 26.81% for the facilities which do not own equipment.
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The average retention rate of PFT equipment is 64.31% in total, 100% in tertiary hospitals, 98.27% in general hospitals, 87.46% in secondary hospitals, and 62.26% in private clinics ( Table 4). The first assessment was based on the COPD claims data from to Apand the second assessment was based on the claims data from to April 16, 2016. In order to improve the quality of care for patients with COPD and to reduce the severity of illness and improve the adequacy of medical care benefits, the Health Insurance Review and Assessment Service (HIRA) conducted an evaluation of adequacy based on COPD claim data. However, there is a gap between the clinical guidelines and the actual clinical care. Current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines provides appropriate guidance for the diagnosis and treatment of patients with COPD and, in fact, it has been shown to reduce the morbidity and mortality rate of COPD patients 6. Although international variation in admission for COPD is 17-fold across OECD countries, Japan is 23.5 much lower than Korea. According to the Organisation for Economic Co-operation and Development (OECD) report, the COPD admission rate per 100,000 population over the age of 16 is 212.2 in Korea and the OECD average is 198.4 5. Worsening of illness and hospitalization of COPD patients can be prevented when an outpatient is effectively treated with well controlled strategy. So, the importance of early detection and intervention of COPD is emphasized 4. With its increasing prevalence, COPD is predicted to be the fourth most frequent cause of death worldwide by 2030 and the economic burden of COPD is also increasing 3. However, only a minority of COPD patients receive physician's diagnosis or treatment not only in its early stages but even when lung function is severely impaired 2. However, according to the fourth Korean National Health and Nutrition Examination Survey conducted in Korea, the prevalence of COPD in subjects aged 40 years and older was 13.4% (males, 19.4% female, 7.9%) 1. COPD is a common, preventable and treatable disease. Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease that causes irreversible airflow limitation.