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Quality Indicators and Outcome Measures of Endoscopy in the National Cancer Screening Program

Yonsei Medical Journal 2019년 60권 11호 p.1054 ~ 1060
 ( Min Jun-Ki ) - Kyung Hee University Hospital at Gangdong Department of Internal Medicine

 ( Cha Jae-Myung ) - Kyung Hee University Hospital at Gangdong Department of Internal Medicine
 ( Kwak Min-Seob ) - Kyung Hee University Hospital at Gangdong Department of Internal Medicine
 ( Yoon Jin-Young ) - Kyung Hee University Hospital at Gangdong Department of Internal Medicine
정윤호 ( Jung Yun-Ho ) - Soonchunhyang University College of Medicine Department of Internal Medicine
신정은 ( Shin Jeong-Eun ) - Dankook University College of Medicine Department of Internal Medicine
 ( Yang Hyo-Joon ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine

Abstract


Purpose: Quality indicators of the National Endoscopy Quality Improvement Program (NEQIP) and outcome measures of endoscopy in the National Cancer Screening Program (NCSP) in Korea are not clear. We evaluated the quality indicators of the revised NEQIP and outcome measures of endoscopy at different types of healthcare facilities participating in the NCSP.

Materials and Methods: This study was conducted between March and August 2018 in primary, secondary, and tertiary healthcare facilities that perform endoscopy as a part of the NCSP. Representative endoscopists completed a questionnaire for quality indicators of the NEQIP and provided data on outcome measures for endoscopy.

Results: Quality indicators of the NEQIP were mostly acceptable. However, the quality indicators for annual volume of esophagogastroduodenoscopy (EGD) and colonoscopy, training for endoscopy quality improvement by endoscopy nursing staff, colonoscopy reports, documentation of pathologic lesions, quality of endoscopy reprocessing areas, and completion of endoscopy reprocessing education programs were suboptimal. For outcome measures of EGD, the number of photo-documentations and total procedure time were higher at tertiary healthcare facilities than at other facilities (p<0.001 and p=0.023, respectively). For the outcome measures of colonoscopy, colonoscopy completion rate and waiting times for colonoscopy were significantly higher at tertiary healthcare facilities than at other facilities (both p<0.001).

Conclusion: Outcome measures of endoscopy should be included as quality indicators of NCSP. However, universal outcome measures for all types of healthcare facilities should be established because performance levels of some outcome measures differ among individual healthcare facility types.

키워드

Colonoscopy; gastroscopy; outcome assessment; quality indicators; mass screening
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