status quo of quo vadis? - KCE

20 Quality development in general practice in Belgium: status quo or quo vadis ? KCE Reports 76
Keypoints from the literature review
• Most papers come from the UK, Australia and the Netherlands. The
major elements in the development of quality systems are a national
policy, a professional leadership and a careful choice of incentives for the
GPs.
• A systematic review concluded that peer reviews, practice audits and
practice visits are the most common instruments used in the quality
systems in general practice. There is a lack of literature about their
effects on the quality of care, even if studies show the satisfaction of the
participants.
• The literature about the UK Quality Outcomes Framework analyses the
positive and negative effects of a pay for quality system. The
implementation of this scheme requires considerable budget and there is
a lack of agreement about the choice of indicators that only reflect a
small part of the GP daily work.
• Three international initiatives refer to the measurement of quality in
general practice i.e., the OECD clinical quality indicators, the European
Practice Assessment instrument and the Maturity Matrix.
• Many papers describe initiatives in self-selected practices and the results
might not be applicable to the whole GP population.
• There is a lack of evidence about the effect of any quality system on the
outcomes at the patient level.
2.4 DESCRIPTION OF THE QUALITY SYSTEM IN THE FIVE
SELECTED COUNTRIES
This analysis begins with an overview of the characteristics of the health care systems of
the five selected countries (see table 3). The information comes mainly from the ‘HIT
Profiles’ of the European Observatory on Health Systems and Policies 80-84,5 and from the
statistics of the Organisation for Economic Co-operation and Development 6 . The
websites of professional bodies, national and international organisations completed this
data source (see appendix 2). The appendix 3 displays the list of native experts who
checked and completed the descriptions of their countries.