Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szécsényi, Joachim

doi:10.1136/bmjopen-2014-007443

Cited by 15 publications

(22 citation statements)

References 19 publications

(26 reference statements)

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“…As a motivational aspect practices get a certificate if they successfully complete EPA. Further information about EPA in Switzerland is given in Goetz et al 20…”

Section: Methodsmentioning

confidence: 99%

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Job satisfaction of primary care physicians in Switzerland: an observational study

Goetz

Jossen²,

Szécsényi

et al. 2016

FAMPRJ

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“…As a motivational aspect practices get a certificate if they successfully complete EPA. Further information about EPA in Switzerland is given in Goetz et al 20…”

Section: Methodsmentioning

confidence: 99%

“…21 Data were collected from 91 practices, which had used the EPA methodology and published elsewhere. 20 190 primary care physicians worked in these practices. Not all physicians enrolled into EPA participated in the job satisfaction survey.…”

Section: Design and Participantsmentioning

confidence: 99%

Job satisfaction of primary care physicians in Switzerland: an observational study

Goetz

Jossen²,

Szécsényi

et al. 2016

FAMPRJ

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“…In general practice, there is a pronounced lack of empirical research on the implementation and impact of accreditation [3] and the sparse evidence on impact is inconclusive. Two before-after studies from Germany and Switzerland reported improvements in practice management from participation in voluntary accreditation under the European Practice Assessment program [7, 8]. However, these studies had important methodological limitations and did not include clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Experiences of accreditation impact in general practice – a qualitative study among general practitioners and their staff

Kousgaard¹,

Thorsen²,

Due³

2019

BMC Fam Pract

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BackgroundAccreditation is a widespread tool for quality management in health care. However, there is lack of research on the impact of accreditation, particularly in general practice. This study explores how general practitioners and their staff experienced the impact of a mandatory accreditation program in Denmark.MethodsQualitative interviews with general practitioners and staff from 11 clinics. The respondents were interviewed twice: during preparation and after the survey visit. The interviews were analyzed using thematic analysis, and all specific changes and other types of impact were extracted from the transcribed interview data from each clinic.ResultsThe impact of accreditation varied markedly among the clinics as did the participants’ overall assessments of accreditation. Concerning specific changes in behavior and physical infrastructure, some clinics had only implemented a few minor changes in response to accreditation, some had made a relatively moderate number of changes, and a few clinics had made relatively many changes including a few pronounced ones. Further, some participants experienced that accreditation had enhanced knowledge sharing or upgraded competencies, and increased job satisfaction. However, the workload related to accreditation was emphasized as a problem by a majority of the professionals and for a few, accreditation had influenced job satisfaction negatively.ConclusionAccreditation may affect general practice clinics in very different ways. In spite of several examples of positive impact, the results suggest that it is difficult to design a mandatory accreditation program for general practice in which most professionals experience that the benefits of accreditation equal the resources used in the process.

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“… 15 These factors have led to poor accessibility and high medical costs for people seeking medical care in hospitals. 16 …”

Section: Introductionmentioning

confidence: 99%

Effect of family practice contract services on the quality of primary care in Guangzhou, China: a cross-sectional study using PCAT-AE

Zhong

Mei

et al. 2018

BMJ Open

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ObjectiveCurrent healthcare reform in China has an overall goal of strengthening primary care and establishing a family practice system based on contract services. The objective of this study was to determine whether contracting a general practitioner (GP) could improve quality of primary care.DesignA cross-sectional study using two-stage sampling conducted from June to September 2014. Propensity score matching (PSM) was employed to control for confounding between patients with and without contracted GP.SettingThree community health centres in Guangzhou, China.Participants698 patients aged 18–89 years.Main outcome measuresThe quality of primary care was measured using a validated Chinese version of primary care assessment tool (PCAT). Eight domains are included (first contact utilisation, accessibility, continuity, comprehensiveness, coordination, family-centredness, community orientation and cultural competence from patient’s perceptions).ResultsA total of 692 effective samples were included for data analysis. After PSM, 94 pairs of patients were matched between the patients with and without contracted GPs. The total PCAT score, continuity (3.12 vs 2.68, p<0.01), comprehensiveness (2.31 vs 2.04, p<0.01) and family-centredness (2.11 vs 1.79, p<0.01) were higher in patients who contracted GPs than those did not. However, the domains of first contact utilisation (2.74 vs 2.87, p=0.14) and coordination (1.76 vs 1.93, p<0.05) were lower among patients contracted with GPs than in those who did not.ConclusionOur findings demonstrated that patients who had a contracted GP tend to experience higher quality of primary care. Our study provided evidence for health policies aiming to promote the implementation of family practice contract services. Our results also highlight further emphases on the features of primary care, first contact services and coordination services in particular.

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Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

Cited by 15 publications

References 19 publications

Job satisfaction of primary care physicians in Switzerland: an observational study

Job satisfaction of primary care physicians in Switzerland: an observational study

Experiences of accreditation impact in general practice – a qualitative study among general practitioners and their staff

Effect of family practice contract services on the quality of primary care in Guangzhou, China: a cross-sectional study using PCAT-AE

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