The selection of Priority Assessment Domains for Evaluating Patient-Reported Outcomes as National Quality Indicator in Korean Healthcare

Purpose: The objective of this study is to develop criteria for selecting suitable areas for measuring PRO in the Korean healthcare system and to prioritize the domains based on these criteria for the PRO introduction.Methods: The study established criteria for prioritizing PRO areas using the RAND/UCLA modified Delphi method, which was conducted with nine experts. The expert group consisted of five academic and clinical experts, two members of the quality evaluation committee and two patient representatives. By conducting two rounds of Delphi surveys, the criteria for selecting areas using PRO were confirmed. After this process, in the clinical areas where ICHOM provides PRO measurement sets, an expert panel survey was conducted to determine five candidate PRO measurement areas. Subsequently, the final prioritized PRO measurement area was selected based on the selection criteria.Results: The selection criteria were composed of 3 categories and 8 items. First category, importance and feasibility, included (1) burden of disease, (2) Importance of PRO measurement and (3) degree of impact on patients' lives. Second category, feasibility, included (4) usability of existing PROMs, (5) possibility of self-report, (6) degree of clinical use, and (7) potential for use of existing projects. Third category, usability, included (8) the possibility of improving the quality of care. Among the areas with the set of PRO measures presented by the ICHOM, hip and knee replacement received high scores in selection criteria excluding the burden of disease.Conclusion: This study provides information on areas of clinical practice where the introduction of PRO is feasible. The implementation of PRO will assist in the efforts to improve the quality of care in healthcare institutions by providing patient-centered outcome data. Also, PRO enables comparisons of outcome data by healthcare providers and provides information to policy makers for improving performance for patients.