status quo of quo vadis? - KCE

86 Quality development in general practice in Belgium: status quo or quo vadis ? KCE Reports 76
Houghton
2004{Houghton, 2004
#319}
Miller 2004{Miller,
2004 #363}
Smith 2004{Smith,
2004 #414}
Engels 2005{Engels,
2005 #268}
Are NHS primary
care performance
indicator scores
acceptable as
markers of
general
practitioner
quality?
Relationship
between general
practitioner
certification and
characteristics of
care
Quality
incentives: the
case of U.K.
general
practitioners
Developing a
framework of,
and quality
indicators for,
general practice
management in
Europe
UK A group of 24 senior
GPs collaborate in a
Delphi procedure.
Mathematical
modeling showed
validity.
Australia 1975 GPs provided
details on 100
consecutive patient
encounters. Data
were linked to
national aggregated
data that were
available because GPs
claim to the
Governement.
The method shows
how numerous
Department of
Health performance
indicators can be
merged into a single
composite
performance score.
We show that this
composite
performance score is
easy to derive,
simple to interpret,
is acceptable to GPs,
and has face validity.
Certification of
general practitioners
has a significant
association with
consultation
behavior and patient
management.
Indicators were test
ordering (i.e.
prostate antigen),
referral for diabetes,
cardiovascular risks,
prescription rates. 5
Items proved
discriminative.
UK Reflective Explains the way
forward to the new
incentive scheme
from historical facts.
The paper describes
the incentive
scheme, discusses its
potential benefits
and risks, and draws
out the implications
for evaluation.
For instance, form
the 1050 points
eligible only 40 are
concerned with
mental health.
Europe A two round Delphi
procedure among
GPs of 6 European
countries (including
Belgium)
It proved possible to
develop a European
set on indicators for
practice management
and organization of
general practices.
Precursor of EPA.