title: Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea.
abstract: OBJECTIVE
  In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions.
  
  
  METHODS
  We surveyed the staff of institutional endoscopic units via e-mail.
  
  
  RESULTS
  Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program.
  
  
  CONCLUSIONS
  Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yu Kyung
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Jeong Seop
authors.initials: JS
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
authors.forename: Dong Su
authors.initials: DS
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Cancer Early Detection Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Yeol
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Cancer Early Detection Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
authors.forename: Il-Kwun
authors.initials: IK
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea.
authors.forename: Jong Pil
authors.initials: JP
authors.lastname: Im
authors.affiliation: Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Cha
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Hyun Gun
authors.initials: HG
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Kil
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
authors.forename: Hang Lak
authors.initials: HL
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Eun Sun
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
authors.forename: Yunho
authors.initials: Y
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Chang Mo
authors.initials: CM
authors.lastname: Moon
keywords: Endoscopy; Mass screening; Quality; Stomach neoplasms