Jun Won Park, Min Jung Kim, Young Kyung Do, Shin-Seok Lee, Kichul Shin
{"title":"韩国新诊断的类风湿关节炎患者的护理质量：一项全国性队列研究","authors":"Jun Won Park, Min Jung Kim, Young Kyung Do, Shin-Seok Lee, Kichul Shin","doi":"10.1093/intqhc/mzaf044","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the quality of care in newly diagnosed RA patients by analyzing conventional disease-modifying antirheumatic drugs (cDMARDs) treatment patterns and healthcare utilization using a nationwide claims database.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted using the Korean Health Insurance Review and Assessment database. Study subjects were those newly diagnosed with RA (ICD-10 code M05, M06) and were prescribed a cDMARD in 2014, with follow-up until 2018. Demographic and clinical information, the level of healthcare facilities (LOH) at which the first prescription claim was made, and subsequent healthcare service utilization were collected. We also analyzed the initial pattern in cDMARD prescription and its retention rate.</p><p><strong>Results: </strong>A total of 21,136 patients were analyzed. Diagnosis of seronegative RA (n = 14,571, 68.9%) was more common than seropositive RA. Seropositive RA was most often discovered in tertiary general hospitals (n = 2,230, 34.0%), whereas seronegative RA was most diagnosed in primary care clinics (n = 7,539, 51.7%) (P < 0.001). The most prescribed initial cDMARD was hydroxychloroquine as monotherapy (n = 9,867, 46.7%). However, methotrexate, a well-established first-line cDMARD, was prescribed in 5,447 (25.8%) patients. The discontinuation rate of cDMARD was higher in seronegative than seropositive patients (65.3% vs. 90.3%) and in patients first diagnosed in community LOH (P for trend < 0.001). The mean number of visits to any outpatient clinics (35/year) was substantially higher than that of the general population. Yet, the number of outpatient visits for RA management was only 2.8/year.</p><p><strong>Conclusion: </strong>The quality of care for newly diagnosed RA patients in South Korea can be improved. Further education on accurate diagnosis and effective treatment is necessary to improve the quality of care provided by other specialists and general practitioners.</p>","PeriodicalId":13800,"journal":{"name":"International Journal for Quality in Health Care","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Quality of care for newly diagnosed patients with rheumatoid arthritis in South Korea: A nationwide cohort study.\",\"authors\":\"Jun Won Park, Min Jung Kim, Young Kyung Do, Shin-Seok Lee, Kichul Shin\",\"doi\":\"10.1093/intqhc/mzaf044\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to evaluate the quality of care in newly diagnosed RA patients by analyzing conventional disease-modifying antirheumatic drugs (cDMARDs) treatment patterns and healthcare utilization using a nationwide claims database.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted using the Korean Health Insurance Review and Assessment database. Study subjects were those newly diagnosed with RA (ICD-10 code M05, M06) and were prescribed a cDMARD in 2014, with follow-up until 2018. Demographic and clinical information, the level of healthcare facilities (LOH) at which the first prescription claim was made, and subsequent healthcare service utilization were collected. We also analyzed the initial pattern in cDMARD prescription and its retention rate.</p><p><strong>Results: </strong>A total of 21,136 patients were analyzed. Diagnosis of seronegative RA (n = 14,571, 68.9%) was more common than seropositive RA. Seropositive RA was most often discovered in tertiary general hospitals (n = 2,230, 34.0%), whereas seronegative RA was most diagnosed in primary care clinics (n = 7,539, 51.7%) (P < 0.001). The most prescribed initial cDMARD was hydroxychloroquine as monotherapy (n = 9,867, 46.7%). However, methotrexate, a well-established first-line cDMARD, was prescribed in 5,447 (25.8%) patients. The discontinuation rate of cDMARD was higher in seronegative than seropositive patients (65.3% vs. 90.3%) and in patients first diagnosed in community LOH (P for trend < 0.001). The mean number of visits to any outpatient clinics (35/year) was substantially higher than that of the general population. Yet, the number of outpatient visits for RA management was only 2.8/year.</p><p><strong>Conclusion: </strong>The quality of care for newly diagnosed RA patients in South Korea can be improved. Further education on accurate diagnosis and effective treatment is necessary to improve the quality of care provided by other specialists and general practitioners.</p>\",\"PeriodicalId\":13800,\"journal\":{\"name\":\"International Journal for Quality in Health Care\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal for Quality in Health Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/intqhc/mzaf044\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal for Quality in Health Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/intqhc/mzaf044","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Quality of care for newly diagnosed patients with rheumatoid arthritis in South Korea: A nationwide cohort study.
Background: This study aimed to evaluate the quality of care in newly diagnosed RA patients by analyzing conventional disease-modifying antirheumatic drugs (cDMARDs) treatment patterns and healthcare utilization using a nationwide claims database.
Methods: This retrospective cohort study was conducted using the Korean Health Insurance Review and Assessment database. Study subjects were those newly diagnosed with RA (ICD-10 code M05, M06) and were prescribed a cDMARD in 2014, with follow-up until 2018. Demographic and clinical information, the level of healthcare facilities (LOH) at which the first prescription claim was made, and subsequent healthcare service utilization were collected. We also analyzed the initial pattern in cDMARD prescription and its retention rate.
Results: A total of 21,136 patients were analyzed. Diagnosis of seronegative RA (n = 14,571, 68.9%) was more common than seropositive RA. Seropositive RA was most often discovered in tertiary general hospitals (n = 2,230, 34.0%), whereas seronegative RA was most diagnosed in primary care clinics (n = 7,539, 51.7%) (P < 0.001). The most prescribed initial cDMARD was hydroxychloroquine as monotherapy (n = 9,867, 46.7%). However, methotrexate, a well-established first-line cDMARD, was prescribed in 5,447 (25.8%) patients. The discontinuation rate of cDMARD was higher in seronegative than seropositive patients (65.3% vs. 90.3%) and in patients first diagnosed in community LOH (P for trend < 0.001). The mean number of visits to any outpatient clinics (35/year) was substantially higher than that of the general population. Yet, the number of outpatient visits for RA management was only 2.8/year.
Conclusion: The quality of care for newly diagnosed RA patients in South Korea can be improved. Further education on accurate diagnosis and effective treatment is necessary to improve the quality of care provided by other specialists and general practitioners.
期刊介绍：
The International Journal for Quality in Health Care makes activities and research related to quality and safety in health care available to a worldwide readership. The Journal publishes papers in all disciplines related to the quality and safety of health care, including health services research, health care evaluation, technology assessment, health economics, utilization review, cost containment, and nursing care research, as well as clinical research related to quality of care.
This peer-reviewed journal is truly interdisciplinary and includes contributions from representatives of all health professions such as doctors, nurses, quality assurance professionals, managers, politicians, social workers, and therapists, as well as researchers from health-related backgrounds.
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