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

Mi Ryoung Seo, Gunwoo Kim, Ki Won Moon, Yoon Kyoung Sung, Jong Jin Yoo, Chong Hyeon Yoon, Eun Bong Lee, Jisoo Lee, Eun Ha Kang, Hyungjin Kim, Eun Jung Park, Wan Sik Uhm, Myeung Su Lee, Seung Won Lee, Byoong Yong Choi, Seung Jae Hong, Han Joo Baek

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


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.

Original languageEnglish
Article numbere109
Pages (from-to)1-13
Number of pages13
JournalJournal of Korean Medical Science
Issue number17
StatePublished - May 2021

Bibliographical note

Funding Information:
The authors thank all members of the voting panel including Seong Wook Kang, Chungnam National University Hospital, Daejeon; Eunmi Koh, Samsung Medical Center, Sungkyunkwan University, Seoul; Sung-Hwan Park, Seoul St. Mary's Hospital, Catholic University Medical College, Seoul; Jung-Yoon Choe, Catholic University of Daegu School of Medicine, Daegu; Chang-Hee Suh, Ajou University School of Medicine, Suwon; Sang-Heon Lee, Konkuk University Hospital, Seoul; Hyun Ah Kim, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.

Funding Information:
This work was supported by the research fund of Rheumatology Research Foundation (RRF-2015-03).

Publisher Copyright:
© 2021 The Korean Academy of Medical Sciences.


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


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