Quality of primary care provided in community clinics in Japan

Abstract

Background Quality indicators (QIs) for primary care are used worldwide. To date, however, the use of QIs to assess the quality of primary care in Japan has not been reported besides diabetes care. Here, we used QIs to evaluate the quality of primary care services provided by local clinics in Japan. Methods Four primary care clinics participated in the retrospective medical chart review in 2015. To assess primary care quality, we used 18 process‐oriented QIs from the Quality Indicators for Primary Care practice in Japan (QIPC‐J) those we previously developed by using a modified Delphi appropriateness method, which comprises 39 QIs in five categories (Comprehensive care/Standardized care, Access, Communication, Coordination, and Understanding of patient's background). Adult subjects were selected from among patients who visited each clinic within the previous one year using medical claims data. We collected data by reviewing medical charts, and calculated the quality score for each QI and clinic. Results A cumulative total of 4330 medical charts were reviewed. The overall quality score was 31.5%. Adherence to QIs ranged from 3.2% to 85.6%. Some quality scores varied substantially between clinics but the overall quality of care among clinics varied less, from 29.2% to 34.0%. Conclusions The quality of primary care services provided by local clinics in Japan varies by both QI and clinic. Strategies to improve the quality of care are warranted.

Quality indicators for primary care and patients’ experience: A leap beyond

“…The use of PCAT is widespread in health services in Brazil, in the states of São Paulo, Rio de Janeiro and especially in Rio Grande do Sul. In agreement with Ozaki et al (2019), 1 when they mention that primary care plays an “increasingly important role in the healthcare system ,” we propose a leap beyond. Why not outline a national policy for primary care assessment including users’ perspective?…”

“…Ozaki et al (2019) 1 had evaluated the quality of primary care throughout small facilities using quality indicators (QIs) collected in electronic medical records (EMR) system. They selected 18 QIs based on a comprehensive framework after a modified Delphi method validated by an expert panel members.…”

Understanding the quality of diabetes care in Japan: a systematic review of the literature

“…After the initial review, we identified 9 articles, 2 were excluded because they did not contain data on metrics limited to Japan and one was excluded because it involved an intervention. In total, 6 studies encompassing 10 cohorts were included in the final analysis [15][16][17][18][19][20][21][22]. (Fig.…”

“…One study used data derived from national health insurance claim data among the elderly [15] and two studies used data from health insurance claims data managed by the Japan Medical Data Center (JMDC) Claims Database [16,18]. One study analyzed the National Database of health insurance claims [19] and another study used medical claims and medical records [20].…”

Author reply to “The importance of patients’ experience in assessing the quality of primary care”

“…We thank the authors of the Letter to the Editor 1 for their interest in our article, "Quality of primary care provided in community clinics in Japan" 2 We completely agree with them that patientcenteredness measured by patients' experience is one of the important elements of quality of primary care, along with equitable, timely, safe, effective, and efficient care 3 We also agree with the authors' suggestion that Japanese healthcare policy should implement patients' experience as Brazilian Federal Government do.…”