status quo of quo vadis? - KCE

90 Quality development in general practice in Belgium: status quo or quo vadis ? KCE Reports 76
Perera 2007{Perera,
2007 #598}
Roland 2004{Roland,
2004 #72}
Panning for gold:
An evidencebased
tool for
assessment of
performance
indicators in
primary health
care
Linking
physicians’ pay to
the quality of
care—a major
experiment in the
United kingdom
New
Zealand
Details the way the
NZ strategy of
identifying indicators
for primary health
care
UK Position paper.
Describes the new
Quality Outcome
Framework which
essentially is an
incentive system
using indicators.
From a definition
and literature, a
framework is
proposed to select
valid indicators for
primary care. Using
the framework
experts may now
review the indicators
that will be used in
the future.
Performance
indicators however,
an not reflect all
aspects of primary
care.
Describes the new
contract in the NHS.
Using clinical and
organizational
indicators and
experiences from
patients, GPs will
have financial
rewards. Claims will
be centrally
collected. Inspection
will include an annual
visit by
representatives of
the Primary Care
Trust. The author
suggests a number of
consequences like
Rapid expansion of
computer systems,
expansion of the
role of nurses in
general practice,
increase in clinics on
specific chronic
diseases, increase of
bio-medical
orientation of GPs,
improvement of
health outcomes,
less holistic
approach, reduction
of care for
conditions not
included in the
incentive system,
increase of
administrative cost
and burden