Beyer M, Gerlach F M, Flies U, Grol R, Król Z, Munck A, Olesen F, O'Riordan M, Seuntjens L, Szecsenyi J
Institute for General Practice, University of Kiel, Kiel, Germany.
Fam Pract. 2003 Aug;20(4):443-51. doi: 10.1093/fampra/cmg420.
Peer review groups (PRGs) and quality circles (QCs) commenced in The Netherlands and have grown to become an important method of quality improvement in primary care in several other European countries.
Our aim was to provide an overview of QC/PRG activities and exemplary programmes in European countries.
A survey was performed in three consecutive steps by EQuiP (European Working Party on Quality in Family Practice), which is a representative association of experts from 26 European countries. The national representatives initially completed a structured questionnaire documenting the number and objectives of QCs/PRGs, sources of support and special programmes in their countries (step 1). In step 2, these sources were used to extend and validate the expert statements. Step 3 studied paradigmatic initiatives in depth.
Step 1 took place in 2000; the response rate was 100% (26 countries). QCs/PRGs were very active in 10 countries; 16 countries showed little or no activity. Participation ranged from <2 to 86% of all GPs. Step 2 concentrated upon the countries with a high level of activity. Development appeared to be associated with establishment in private practice and the portion of GPs with vocational training. Eight programmes from six countries describing the establishment and the targeting of QC/PRG work are presented as case reports (step 3).
In the last 10 years, substantial development of QCs/PRGs has taken place in The Netherlands, the UK, Denmark, Belgium, Ireland, Sweden, Norway, Germany, Switzerland and Austria. Further evaluation is needed to clarify the impact on quality of care.
同行评审小组（PRG）和质量改进小组（QC）起源于荷兰，并在其他几个欧洲国家发展成为基层医疗质量改进的重要方法。
我们的目的是概述欧洲国家的质量改进小组/同行评审小组活动及示范项目。
欧洲家庭医疗质量工作小组（EQuiP）分三个连续步骤进行了一项调查，该小组由来自26个欧洲国家的专家代表组成。各国代表首先填写一份结构化问卷，记录本国质量改进小组/同行评审小组的数量和目标、支持来源及特殊项目（第一步）。在第二步中，利用这些来源扩展并验证专家陈述。第三步深入研究典型倡议。
第一步于2000年进行；回复率为100%（26个国家）。质量改进小组/同行评审小组在10个国家非常活跃；16个国家几乎没有或没有此类活动。参与率在所有全科医生的2%至86%之间。第二步集中于活动水平较高的国家。发展似乎与私人执业机构的设立以及接受职业培训的全科医生比例有关。来自六个国家的八个项目描述了质量改进小组/同行评审小组工作的设立和目标定位，作为案例报告呈现（第三步）。
在过去十年中，荷兰、英国、丹麦、比利时、爱尔兰、瑞典、挪威、德国、瑞士和奥地利的质量改进小组/同行评审小组有了显著发展。需要进一步评估以阐明其对医疗质量的影响。
