Gené-Badia Joan, Ascaso Carlos, Escaramis-Babiano Georgia, Sampietro-Colom Laura, Catalán-Ramos Arantxa, Sans-Corrales Mireia, Pujol-Ribera Enriqueta
Institut Català de la Salut (ICS), Spain.
Fam Pract. 2007 Feb;24(1):41-7. doi: 10.1093/fampra/cml056. Epub 2006 Nov 1.
Health organisations continually seek good output indicators of family medicine health care provision because they are accountable to society, they need to compare services, and need to evaluate the impact of organisational reforms.
Using the sources of information routinely available in health-service management, we sought to assess the groups of components of primary health care output that best serve to define the outcome of family medicine services.
Cross-sectional descriptive study. SITE: Primary health care in Catalunya.
213 primary health care teams.
Information was collected on team structure, user satisfaction, quality-of-professional-life of the health care professionals, and physicians' drug prescription. Confirmatory Factor Analysis was used to assess the number of dimensions that best explained the family medicine outcome.
The model that best fits the structure of the data (AGFI=0.778) is that which consists of three dimensions i.e. (1) the individual accessibility to the services and professional-patient relationship; (2) the coordination within the health care team; (3) the scientific-technical quality of the service. The first two of these dimensions were correlated between themselves, but the third was totally independent of the other two.
Using sources of information that are routinely employed in primary health care services management, the model enables the measurement of the output of family medicine by considering the dimensions such as inter-personnel relationships, internal coordination of the team and the scientific-technical quality of the service. Despite its simplicity, this measure of the output incorporates the views not only of the users but of the health care professionals, as well.
卫生组织不断寻求家庭医学保健服务的良好产出指标，因为它们对社会负有责任，需要比较服务情况，并评估组织改革的影响。
利用卫生服务管理中常规可得的信息来源，我们试图评估最能界定家庭医学服务结果的初级卫生保健产出的组成部分组。
横断面描述性研究。地点：加泰罗尼亚的初级卫生保健。
213个初级卫生保健团队。
收集了有关团队结构、用户满意度、卫生保健专业人员的职业生活质量以及医生的药物处方的信息。使用验证性因素分析来评估最能解释家庭医学结果的维度数量。
最符合数据结构的模型（AGFI = 0.778）由三个维度组成，即：（1）服务的个人可及性和专业人员与患者的关系；（2）卫生保健团队内部的协调；（3）服务的科学技术质量。前两个维度相互关联，但第三个维度与其他两个维度完全独立。
利用初级卫生保健服务管理中常规使用的信息来源，该模型能够通过考虑人际关系、团队内部协调和服务的科学技术质量等维度来衡量家庭医学的产出。尽管该产出衡量方法简单，但它不仅纳入了用户的观点，也纳入了卫生保健专业人员的观点。
