Meuwissen Liesbeth E, de Bakker Dinny H
Nederlands instituut voor onderzoek van de gezondheidszorg (NIVEL), Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A180.
To develop a method to evaluate patients' experiences with general practice care in a scientifically sound manner and to enable comparisons to be made between general practices: the 'Consumer quality'(CQ)-index 'General practice care'.
Cross-sectional observational research.
Through the use of questionnaires the CQ-index asks patients about their experiences with, and the importance they attach to, the different aspects of care provided in general practice by general practitioners, assistants, and other healthcare providers. The CQ-index was based on existing questionnaires and focus group discussions, and consists of a questionnaire concerning experiences and one concerning the importance of those experiences. These were distributed in a random sample among 400 and 100 patients respectively per practice in 32 participating general practices in Rotterdam and Drenthe, the Netherlands. The questionnaire was validated with the help of explorative factor analysis, reliability analysis and multilevel analysis.
The net response to the experiences' questionnaire was 47.6 %. The validated questionnaire contained 8 significant scales, with Cronbach's alpha of at least 0.70. There appeared to be considerable differences between practices. The biggest differences concerned accessibility and availability, a serious bottleneck in many practices. On most scales 100 respondents were sufficient to establish statistically significant differences between practices, when corrected for age, gender, educational level and health status. On the whole, assessment of general practice care was positive, as shown by an average score of 8.1 given to the practices, on a scale of 0-10. Participating general practitioners recognised their practices in the results.
With the CQ-index 'General practice care' a valid instrument has been introduced, suitable for evaluating patient's experiences and for comparing general practices with each other.
开发一种以科学合理的方式评估患者对全科医疗服务体验的方法，并能够在不同的全科医疗机构之间进行比较：即“消费者质量”（CQ）指数“全科医疗服务”。
横断面观察性研究。
通过问卷调查，CQ指数询问患者对全科医生、助理及其他医疗服务提供者在全科医疗中提供的不同方面服务的体验，以及他们对这些方面的重视程度。CQ指数基于现有的问卷和焦点小组讨论，由一份关于体验的问卷和一份关于这些体验重要性的问卷组成。在荷兰鹿特丹和德伦特省的32家参与研究的全科医疗机构中，分别随机抽取400名和100名患者发放这些问卷。借助探索性因素分析、信度分析和多水平分析对问卷进行了验证。
体验问卷的有效回复率为47.6%。经过验证的问卷包含8个有效量表，克朗巴哈系数至少为0.70。不同医疗机构之间存在显著差异。最大的差异在于可及性和可得性，这是许多医疗机构的严重瓶颈。在大多数量表上，校正年龄、性别、教育水平和健康状况后，100名受访者足以确定不同医疗机构之间的统计学显著差异。总体而言，对全科医疗服务的评价是积极的，各医疗机构的平均得分为8.1分（满分10分）。参与研究的全科医生认可研究结果中对他们医疗机构的评价。
通过“消费者质量”（CQ）指数“全科医疗服务”，引入了一种有效的工具，适用于评估患者的体验并在不同的全科医疗机构之间进行相互比较。
