J Korean Med Sci.  2021 May;36(17):e109. 10.3346/jkms.2021.36.e109.

Quality Indicators for Evaluating the Health Care of Patients with Rheumatoid Arthritis: a Korean Expert Consensus

• Seo MR
• Kim G
• Moon KW
• Sung YK
• Yoo JJ
• Yoon CH
• Lee EB
• Lee J
• Kang EH
• Kim H
• Park EJ
• Uhm WS
• Lee MS
• Lee SW
• Choi BY
• Hong SJ
• Baek HJ

• KMID: 2515803
• DOI: http://doi.org/10.3346/jkms.2021.36.e109

Abstract

Background
There is increasing interest in the quality of health care and considerable efforts are being made to improve it. Rheumatoid arthritis (RA) is a disease that can result in favorable outcomes when appropriate diagnosis and treatment are provided. However, several studies have shown that RA is often managed inappropriately. Therefore, the Korean College of Rheumatology aimed to develop quality indicators (QIs) to evaluate and improve the health care of patients with RA.
Methods
Preliminary QIs were derived based on the existing guidelines and QIs for RA. The final QIs were determined through two separate consensus meetings of experts. The consensus was achieved through a panel of experts who voted using the modified Delphi method.
Results
Fourteen final QIs were selected among 70 preliminary QIs. These included early referral to and regular follow-up with a rheumatologist, radiographs of the hands and feet, early initiation and maintenance of disease-modifying anti-rheumatic drug (DMARD) therapy, periodic assessment of disease activity, screening for drug safety and comorbidities,including viral hepatitis and tuberculosis before biologic DMARD therapy, periodic laboratory testing, supplementation with folic acid, assessment of the risk for cervical spine instability before general anesthesia, patient education, and specialized nurse.
Conclusion
These QIs can be used to assess and improve the quality of health care for patients with RA.

Keyword

Quality Indicators; Health Care; Arthritis; Rheumatoid; Quality of Health Care; Disease Management