status quo of quo vadis? - KCE

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88 Quality development in general practice in Belgium: status quo or quo vadis ? KCE Reports 76 Brown 2006{Brown, 2006 #236} Doran 2006{Doran, 2006 #71} Engels 2006{Engels, 2006 #527} Fraser 2006{Fraser, 2006 #535} Cross sectional study of performance indicators for English Primary Care Trusts: testing construct validity and identifying explanatory variables Pay-forperformance programs in family practices in the United Kingdom Testing a European set of indicators for the evaluation of the management of primary care practices Evaluation of an inter-practice visit peer review program for rural Australian general practice registrars UK Secondary analysis of the aggregated QOF scores of GPs with 6 Performance Indicators in 303 English primary Care Trusts. UK Secondary analysis of the QOF scores and exception rates per condition. QOF scores were correlated with socio demographic data of GPs and practices. Europe Validation and feasibility study in 9 countries of a European instrument of practice management and organization. Australia Qualitative analysis of a project where consultations of GPs were observed by peers in 18 practices. In the UK Primary Care Trusts are the umbrella of GPs in a region. Within the QOF it shows that there is some correlation between the QOF scores and patient satisfaction but not with other measures. The results of this analysis provide little evidence that the current indicators have sufficient construct validity to measure the underlying concept of quality, except when the specific area of screening is considered. The median reported and claims achievement was 83,4 percent. Sociodemographic effects of both practices and patients had moderate but significant effects. Exception reporting was high in a about 1 percent of practices. These practices should be monitored. 57 indicators were found to be valid in all countries. In some countries resistance was reported among practice staff but could be overcome. Procedures were sometimes slowly implemented. The visitor learns. No data on the observed GP.
KCE Reports 76 Quality development in general practice in Belgium: status quo or quo vadis ? 89 Lester 2006{Lester, 2006 #346} Marshall 2006{Marshall, 2006 #352} Morgan 2006{Morgan, 2006 #366} Rhydderch 2006{Rhydderch, 2006 #95} Wang 2006{Wang, 2006 #447} The quality and outcomes framework of the GMS contract: a quiet evolution for 2006 OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion Primary care funding, contract status, and outcomes: an observational study Assessing organisational development in family practice. The Maturity Matrix Practice size and quality attainment under the new GMS contract: a cross-sectional analysis UK Reflective paper There is uncertainty if the QOF has made a difference to patient care. Authors plead for more incorporation of skillful communication as Europe and USA and Canada Selection from lists of existing indicators by a modified Delphi technique among experts to arrive at a European set of indicators for primary care (which encompasses GP) UK Secundary analysis of the QOF related to contrcat status of GPs Europe Qualitative study to develop a faciliting model for quality development. UK Secondary analysis of QOF and routinely available data part of the QOF. Indicators were drawn from the USA, UK and Canada. After first appreciation 270 indicators were identified out of more than 1000. Authors report high time constraints. The paper helps understanding international trends and policies towards quality care QOF scores tend to be lower among practices that have a larger part of fixed payments for services not in the QOF The Matury Matrix{Elwyn, 2004 #524} is a facilitation model designed to assess organizational development in general practice settings and stimulate quality development. Lessons are drawn for visitors and the process of the visits Small practices were more likely to be in underprivileged areas. They contain as many clinical indicators but have lower achievement on organizational indicators
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