Acceptability of Components for a Mandatory Quality Improvement Framework: A Survey Among Swiss General Practitioners

Abstract

Background: In Switzerland, recently introduced legislation requires the implementation of a framework for mandatory quality improvement at the level of individual general practitioners (GPs) and includes the introduction of quality indicators (QIs) amongst other components. The GP-sided acceptance of potential components of such a framework is important to its success.

Objectives: To identify components of a potential framework for mandatory quality improvement that are most likely to be accepted by Swiss GPs.

Design: Cross-sectional web-based survey conducted among employed and self-employed Swiss GPs in 2024.

Methods: The survey was distributed to 1103 Swiss GPs via their physician networks. The survey inquired the acceptability of 62 possible components of a mandatory framework for quality improvement. Components were categorized as "acceptable" if they were rated as "acceptable" or "very acceptable" by more than 50% of participants, in contrast to those rated as "neutral" or "not acceptable."

Results: A total of 244 GPs participated (participation rate 22.1%, 53.0% male, 51.2% <50 years old, 50.8% employed). The majority of participants rated 31 of the proposed 62 components as acceptable. Among these were QIs pertaining to structures and processes of care (rated as acceptable by 58.3%-83.4%) and sharing QI achievement data with peers from different group practices and physician networks (53.9%-92.2%). A majority of participants accepted physician networks, medical associations, and academic institutions as entities that could establish QIs and manage QI data (acceptance 62.1%-88.8%).

Conclusions: Swiss GPs appear to accept QIs that reflect structures and processes of care established by physician networks, medical associations or academic institutions, exclusively shared among their peers.

Keywords: Switzerland; access; and evaluation; health care; health care quality; health policy; physician; primary health care; general practitioners; quality assurance; quality improvement; surveys and questionnaires.

Figure 1.

Likert plot for questions asking about acceptance of different types of quality indicators (QIs): participants’ acceptance ratings of the QI types are represented in the horizontal bars and the numbers in % (rounded) at the side and in the center summarize the response categories (left = % rather unacceptable or completely unacceptable, center = % neutral/cannot answer, right = % rather acceptable or fully acceptable).

Figure 2.

Acceptance of sharing achievement data from different types of QIs with specific bodies. Likert plot for questions asking about acceptance of sharing QI achievement data of different types of quality indicators (QIs) with different entities: participants’ acceptance ratings are represented in the horizontal bars and the numbers in % (rounded) at the side and in the center summarize the response categories (left = % rather unacceptable or completely unacceptable, center = % neutral/cannot answer, right = % rather acceptable or fully acceptable).

Figure 3.

Acceptance of entities establishing QIs, gathering and managing QI data. Likert plot for questions asking about acceptance of entities establishing quality indicators (QIs), gathering and managing QI data: participants’ acceptance ratings are represented in the horizontal bars and the numbers in % (rounded) at the side and in the center summarize the response categories (left = % rather unacceptable or completely unacceptable, center = % neutral/cannot answer, right = % rather acceptable or fully acceptable). EMR: electronic medical records, PIS: practice information system.

Figure 4.

Acceptance of financing sources and incentives. Likert plot for questions asking about acceptance of financing sources and incentives for quality improvement: participants’ acceptance ratings are represented in the horizontal bars and the numbers in % (rounded) at the side and in the center summarize the response categories (left = % rather unacceptable or completely unacceptable, center = % neutral/cannot answer, right = % rather acceptable or fully acceptable).