Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Division of Rheumatology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
J Korean Med Sci. 2021 May 3;36(17):e109. doi: 10.3346/jkms.2021.36.e109.
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.
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.
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.
These QIs can be used to assess and improve the quality of health care for patients with RA.
人们对医疗保健质量的关注度日益提高，并且正在做出相当大的努力来改善医疗保健质量。类风湿关节炎（RA）是一种可以通过提供适当的诊断和治疗获得良好结果的疾病。然而，多项研究表明，RA 的治疗往往并不恰当。因此，韩国风湿病学会旨在制定质量指标（QIs）来评估和改善 RA 患者的医疗保健。
初步的 QIs 是基于现有的指南和 RA 的 QIs 得出的。最终的 QIs 通过两次专家共识会议确定。共识是通过专家小组使用修改后的 Delphi 方法投票达成的。
在 70 个初步 QIs 中，选择了 14 个最终的 QIs。这些 QIs 包括早期转介给风湿病专家并定期随访、手部和足部的 X 光片、早期开始和维持疾病修饰抗风湿药物（DMARD）治疗、定期评估疾病活动度、筛查药物安全性和合并症（包括在使用生物 DMARD 治疗前筛查病毒性肝炎和结核病）、定期实验室检查、补充叶酸、在全身麻醉前评估颈椎不稳定的风险、患者教育和专门护士。
这些 QIs 可用于评估和改善 RA 患者的医疗保健质量。
