Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea

BACKGROUND/AIMS: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions. METHODS: We surveyed the staff of institutional endoscopic units via e-mail. RESULTS: Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program. CONCLUSIONS: Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

Health-Related Quality of Life in Korean Patients with Chronic Diseases / 대한류마티스학회지

OBJECTIVE: Few studies have examined the impact of chronic diseases on populations using a comprehensive health-related quality of life (HRQOL) in Korea. We assessed HRQOL of patients with 16 common chronic diseases. METHODS: We interviewed patients with chronic diseases (n=980) and healthy control (n=288) using two HRQOL measurements: Korean Medical Outcome Study Short Form-36 (KSF-36) and Korena EuroQol-5 Dimensions (KEQ-5D), and questions on sociodemographic and clinical characteristics. RESULTS: Each illness had a distinctive profile. Among disease groups, the KSF-36 global health score was highest in DM and lowest in fibromyalgia. The KSF-36 physical component summary score was highest in DM and lowest in osteoarthritis . The KSF-36 mental component summary score was highest in hypertension and lowest in fibromyalgia. The KEQ-5D utility score was highest in DM and lowest in fibromyalgia. The KEQ-5D visual analog score was highest in DM and lowest in liver cirrhosis. In correlation analysis, the KSF-36 physical component summary, mental component summary and five domains in KEQ-5D were well correlated with each others. CONCLUSION: Health related quality of life in Korean patients with chronic disease is lower than healthy control. Patients with hypertension and DM registered the two highest scores in global health but patients with fibromyalgia reported the worst health experience in global health.We can compare the profiles of the groups and determine the relative impact on the patients of the various diseases and these data will provide a baseline of the current health related quality of life of individuals suffering from a variety of conditions.