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  • Low level of under-reporting of detected TB cases in the Republic of Korea

    Background and Methods

    A national case-based internet-based TB notification system is a key element of Korea’s TB control programme, linked to the initiation of response measures including outbreak investigations, evaluation of contacts and TB case management. The online TB reporting system was established in 2000 (Lew 2006).

    All TB patients who are treated in public health centers are notified to the Korea National TB Surveillance System (KNTSS). In 2006, a national survey found that only 67.6% of patients diagnosed and treated in the private sector were notified, despite a legal framework making notification of TB cases mandatory. Since 2008, the coverage of routine TB surveillance has been systematically assessed using record-linkage of medical records from the National Health Insurance (NHI) and records from the KNTSS database(Park 2012). National identification numbers are used for record-linkage.

    Results

    Under-reporting of TB case notifications over 2012-2013 are presented in the table below. Under-reporting was defined as failing to report within 6 months.

    Under-reporting of detected cases in Korea
    2012 2013
    NHI 36735 33800
    KNTSS 32515 31534
    Under-reporting 11.5% 6.7%

    Under-reporting to KNTSS was found lower when cases were diagnosed in General hospitals (8% over 2012-2013) compared with private clinics (24%). A regulation is being put in place to condition reimbursements from NHI to notification of cases by prescribing physicians as part of a 5-year plan for TB elimination (2013-2017). As of 2011, NHI covered 90% of medical expenses related to TB, it is planned that reimbursement coverage will reach 100% for TB patients in 2016. The new conditional reimbursement regulation and planned 100% coverage should ensure a near zero level of under-reporting of detected cases in the near future.

    References

    1. WJ Lew, EG Lee, JY Bai, HJ Kim, GH Bai, DI Ahn, JK Lee, SJ Kim. An Internet-based surveillance system for tuberculosis in Korea.. Int J Tuberc Lung Dis 10, 1241-7 (2006).

    2. YS Park, SJ Hong, YK Boo, ES Hwang, HJ Kim, SH Cho, KI Na, EH Cho, SS Shin. The national status of tuberculosis using nationwide medical records survey of patients with tuberculosis in Korea.. Tuberc Respir Dis (Seoul) 73, 48-55 (2012).