Background: The Health Insurance Review and Assessment Service (HIRA) is responsible for the review, quality assessment, and the setting and management of benefit standards of the National Health Insurance in South Korea. HIRA operates a variety of separate committees, including the Healthcare Review and Assessment Committee. Each committee reviews and evaluates matters regarding the decision making for NHI coverage.
Objectives: Each committee requires contextualisation for decision making for NHI coverage. The review results should be evidence based, reflecting the importance of a fair, specialised, objective approach. In order to achieve such objectivity, we introduce and suggest future directions for the evidence-based decision supporting system in HIRA.
Methods: The Evidence-Based Review Manual (EBRM) unique to HIRA was developed to standardise the rapid-review format for meeting materials based on a manual. The EBRM Master Program was also set up to encourage continuous training in HIRA.
Results: According to the EBRM guideline, the standard format documents are produced for an efficient decision-making process. The EBRM are composed 4 step: 1) Item→ 2) Regulation & Institute opinion→ 3) Rapid-evidence review method→ 4) item discussion. Rapid-evidence reviews in EBRM (3rd step) are composed: text book, Clinical guidelines in medical standard, rapid review in scientific evidence, supplement. The current guideline has formed the basis for the preparation of conference materials, ensuring that Committee meetings.
EBRM Masters obtain on internal qualification of HIRA, and serve to improve utilisation of evidence and co-operation between staff (114 persons of the EBRM certification in 2007~2016). The qualification programme included the fields of the statistics, epidemiology, theory and practice education of EBRM rapid-review method.
Conclusions: For the future, HIRA has tried to develop the efficient rapid-review method (EBRM) and to enhance the accessibility for systemised programmes (web-based education system). HIRA continues to make efforts for the advancement of an evidence-based decision-making system.