Quality in primary care
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Quality in primary care · Jan 2011
Reducing variation in general practitioner referral rates through clinical engagement and peer review of referrals: a service improvement project.
General practitioner (GP) referral rates to hospital services vary widely, without clearly identified explanatory factors, introducing important quality and patient safety issues. Referrals are rising everywhere year on year; some of these may be more appropriately redirected to lower technology services. ⋯ This intervention appeared acceptable to GPs because of its emphasis on reviewing appropriateness and quality of referrals and was effective and sustainable while the investment in resources continued. Consultant involvement in discussions appeared important. The intervention's cost-effectiveness requires evaluation for consideration of future referral management strategies.
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All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would benefit from the contribution of health services research (HSR) on a wide range of topics. As funding for such research is limited, priorities need to be defined. ⋯ Given funding constraints, it is imperative that research priorities are identified to ensure that resources are devoted to the most pressing and important issues facing primary care. Priority areas for future research are amongst others the evaluation of primary care reforms in Europe, and the relations between primary and secondary care.
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Quality in primary care · Jan 2011
ReviewA strategy for the implementation of a quality indicator system in German primary care.
The Quality and Outcomes Framework (QOF) has had a major impact on the quality of care in British general practice. It is seen as a major innovation amongst quality indicator systems and as a result various countries are looking at whether such initiatives could be used in their primary care. In Germany also the development of similar schemes has started. ⋯ For the successful implementation of a quality indicator system in German primary care a number of key issues, as presented in this article, need to be taken into account.
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Quality in primary care · Jan 2011
The SHARE frailty instrument for primary care predicts incident disability in a European population-based sample.
The adoption of a frailty paradigm in primary care would be helpful to identify adults who need priority access to specialised resources. The frailty phenotype by Fried et al is a popular operationalisation of frailty, but it is not easily applicable in routine primary care practice. We recently created and validated a frailty instrument based on the Survey of Health, Ageing and Retirement in Europe (SHARE-FI), in order to provide primary care practitioners with an easy, reliable and freely accessible tool for the assessment and monitoring of frailty in community dwelling adults over the age of 50 years (www.biomedcentral.com/1471-2318/10/57). ⋯ SHARE-FI may contribute to quality in primary care by offering a quick and reliable way to assess and monitor frailty in community dwelling individuals over the age of 50 and prioritize their access to resources, and it serves as a novel tool for audit and research.