Quality of care in inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 2(nd) Asian Organization of Crohn's and Colitis (AOCC) meeting in Seoul

Abstract

Background/aims: The quality of care in inflammatory bowel disease (IBD) has not been systematically estimated. The aim of this study was to investigate the current status of quality of IBD care in Asian countries.

Methods: A questionnaire-based survey was conducted between March 2014 and May 2014. The questionnaire was adopted from "An adult inflammatory bowel disease physician performance measure set" developed by the American Gastroenterological Association. If the respondent executed the performance measure in more than 70% of patients, the measure was regarded as well performed.

Results: A total of 353 medical doctors from Asia completed the survey (116 from Korea, 114 from China, 88 from Japan, 17 from Taiwan, 8 from Hong-Kong, 4 from India, 3 from Singapore, and 1 each from the Philippines, Malaysia and Indonesia). The delivery of performance measures, however, varied among countries. The documentation of IBD and tuberculosis screening before anti-tumor necrosis factor therapy were consistently performed well, while pneumococcal immunization and prophylaxis of venous thromboembolisms in hospitalized patients were performed less frequently in all countries. Physician awareness was positively associated with the delivery of performance measures. Variations were also noted in reasons for non-performance or low performance of quality measures, and the two primary reasons cited were consideration of the measure to be unimportant and lack of time.

Conclusions: The delivery of performance measures varies among physicians in Asian countries, and reflects variations in the quality of care among the countries. This variation should be recognized to improve the quality of care in Asian countries.

Keywords: Asia; Inflammatory bowel diseases; Quality indicators; Quality of care.

Fig. 1. Delivery and awareness of performance measures in Asian countries. Delivery of performance measures varied significantly among Asian countries. Other Asian countries include Taiwan, Hong-Kong, India, Singapore, the Philippines, Malaysia, and Indonesia. Performance measures were arranged in order that well delivered. C. difficile, Clostridium difficile; VTEs, venous thromboembolisms.

Fig. 2. The association between awareness and delivery of performance measures. The association between the delivery and awareness of performance measures varied among Asian countries. Other Asian countries include Taiwan, Hong-Kong, India, Singapore, the Philippines, Malaysia, and Indonesia. The awareness had positive association to the delivery of performance measures. ^aPerformance measure that had a significant relationship between awareness and performance (P<0.05). VTEs, venous thromboembolisms; TNF, tumor necrosis factor.

Fig. 3. Reasons for non-performance of quality measures in Asian countries. Reasons cited for non-performance of quality measures varied among Asian countries. Other Asian countries include Taiwan, Hong-Kong, India, Singapore, the Philippines, Malaysia, and Indonesia. TNF, tumor necrosis factor.