Measuring Quality in Primary Healthcare - Opportunities and Weaknesses
- PMID: 31275436
- PMCID: PMC6598390
- DOI: 10.2478/sjph-2019-0013
Measuring Quality in Primary Healthcare - Opportunities and Weaknesses
Abstract
The easy access to data from electronic patient records has made using this type of data in pay-for-performance systems increasingly common. General practitioners (GPs) throughout Europe oppose this for several reasons. Not all data can be used to derive good quality indicators and quality indicators can't reflect the broad scope of primary care. Qualities like person-centred care and continuity are particularly difficult to measure. The indicators urge doctors and nurses to spend too much time on the registration and administration of required data. However, quality indicators can be very useful as starting points for discussions about quality in primary care, with the purpose being to initiate, stimulate and support local improvement work. This led to The European Society for Quality and Patient Safety in General Practice (EQuiP) feeling the urge to clarify the different aspects of quality indicators by updating their statement on measuring quality in Primary Care. The statement has been endorsed by the Wonca Europe Council in 2018.
Dostop do podatkov iz elektronskih zapisov o bolnikih je enostaven, zato se ti podatki vedno pogosteje uporabljajo kot podlaga za plačilo zdravnikov družinske medicine po uspešnosti. Ti po vsej Evropi temu iz več razlogov vedno odločneje nasprotujejo. Za vrednotenje kakovosti na osnovi kazalnikov ni mogoče uporabiti vseh podatkov, kazalniki kakovosti pa ne morejo odražati širokega obsega primarne oskrbe. Posebno težko je meriti lastnosti, kot sta oskrba, osredotočena na posameznika, in dolgotrajna oskrba. Registracija in upravljanje potrebnih podatkov namreč zdravstveno osebje časovno precej obremenijo. Vendar pa so kazalniki kakovosti lahko zelo koristni kot izhodišča za razprave o kakovosti v primarni zdravstveni oskrbi z namenom, da bi zasnovali, spodbudili in podprli izboljšanje kakovosti dela. Zato je Evropska skupina za kakovost in varnost pacientov v družinski medicini (EQuiP) objavila izjavo o merjenju kakovosti v primarni oskrbi. Leta 2018 jo je potrdilo tudi Evropsko združenje zdravnikov družinske medicine.
Keywords: healthcare; peer group education; primary healthcare; quality circles; quality improvement; quality indicators; reimbursement mechanisms.
Conflict of interest statement
Conflicts of interest: The authors declare that no conflicts of interest exist.
References
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- Peckham S, Wallace A. Pay for performance schemes in primary care: what have we learnt? Qual Prim Care. 2010;18:111–6. - PubMed
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- Measuring quality in primary health care, EQuiP position paper. 2019. http://equip.woncaeurope.org/sites/equip/files/documents/publications/of... Accessed May 16th.
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