Level of Competencies of Family Physicians in Kosovo from Different Perspectives

Abstract

Aim:The aim of this analysis was to compare the level of self-perceived competencies of primary health care physicians in Kosovo with patients’ viewpoint, as well as the necessary (required) level of such competencies from decision-makers’ standpoint.Methods:Three cross-sectional studies were carried out in Kosovo in 2013 including: i) a representative sample of 1340 primary health care users aged ≥18 years (49% men; overall mean age: 50.5±17.9 years; response rate: 89%); ii) a representative sample of 597 primary health care physicians (49% men; overall mean age: 46.0±9.4 years; response rate: 90%), and; iii) a nationwide representative sample of 100 decision-makers operating at different primary health care institutions or public health agencies in Kosovo (63% men; mean age: 47.7±5.7 years). A structured self-administered questionnaire (consisting of 37 items) was used in the three surveys in order to assess physicians’ competencies regarding different domains of the quality of health care.Results:There was a significant gap in the level of self-perceived physicians’ competencies and patients’ perspective in transitional Kosovo. Furthermore, there was a gap in the level of self-perceived physicians’ competencies and the necessary (required) level of physicians’ competencies from decision-makers perspective which was less evident in Prishtina, but considerable in the other regions of Kosovo.Conclusion:Our analysis provides valuable evidence about the level of competencies of primary health care physicians in Kosovo from different stakeholders’ perspectives. There is an urgent need for continuous professional development of family physicians in post-war Kosovo.

Level of competencies of family physicians from patients’ viewpoint in post-war Kosovo

“…There were no sex-differences with regard to the perceived levels of family physicians' competencies according to patients' standpoint. As pointed out earlier, this finding related to a high level of family physicians' knowledge and competencies is in line with the very positive assessment of the quality of primary health care services among our study participants (13). Thus, in our study, 75% of participants perceived as "good" or "very good" the medical encounter, a finding which is quite different from a previous study conducted in Gjilan region, Kosovo, in 2010 including a representative sample of 1039 primary health care users (14).…”

“…The assessment instrument administered in our study sample showed a very high internal consistency, which was similar in male and female participants. As a matter of fact, the overall internal consistency in our survey (Cronbach's alpha=0.96) was higher than in a prior cross-cultural adaptation exercise conducted in Kosovo, which reported an overall Cronbach's alpha=0.88 (11). In addition, the internal consistency in the current study conducted in Kosovo was higher than in a previous validation study conducted in Albania (9).…”

“…On the other hand, the prior survey conducted in Gjilan region included other important dimensions of the quality of primary health care services which are not related to the level of knowledge, skills and competencies of health care professionals (14). Furthermore, the overall level of competencies of family physicians in our study was higher compared to the previous validation study (cross-cultural adaptation) which was conducted in a sample of 98 primary health care users in Kosovo (11). In addition, the overall summary score in our study was particularly higher compared to prior reports from the neighboring Albania, where a similar survey employing exactly the same instrument was conducted (9,10).…”

“…All participants included in this survey were asked to assess the level of skills, abilities and competencies of their family physicians with regard to the following six crucial domains of the quality of primary health care: (i) Patient care and safety (8 items); (ii) Effectiveness and efficiency (7 items); (iii) Equity and ethical practice (8 items); (iv) Methods and tools (5 items); (v) Leadership and management (4 items), and; (vi) Continuing professional development (5 items). Answers for each item of each subscale ranged from 1 ("novice"= physicians have little or no knowledge/ability, or no previous experience of the competency described and need close supervision or instruction) to 5 ("expert"=physicians are the primary sources of knowledge and information in the medical field) (9)(10)(11)(12). An overall summary score [including 37 items; range: from 37 (minimal competencies) to 185 (maximal competencies)] was calculated for all participants included in this study.…”

“…This measuring instrument has been validated in Albania among primary health care users (9) and in general practitioners and family physicians (10). More recently, a cross-cultural adaptation of this instrument has been also conducted in Kosovo among primary health users (11) and family physicians (12). In this framework, we aimed to assess the level of skills, abilities and competencies of family physicians from primary health care users' perspective in Kosovo, a transitional country in the Western Balkans.…”