Webb S J, Dowell A C, Heywood P
Department of General Practice, University of Leeds, St James's Hospital.
BMJ. 1991 Feb 16;302(6773):390-2. doi: 10.1136/bmj.302.6773.390.
To determine general practitioners' attitudes to medical audit and to establish what initiatives are already being undertaken; to define future ideas for audit and perceived difficulties in implementing audit in primary care.
Analysis of responses to a self administered postal questionnaire.
Urban conurbation with a population of about 750,000.
386 general practitioners on the general medical list of Leeds Family Practitioner Committee.
Extent of recording of practice activity data and outcome measures and clinical data, use of data, and audit performed; ideas for audit and perceived difficulties.
317 doctors responded to the questionnaire (individual response rate 82%) from 121 practices (practice response rate 88%). In all, 206 doctors thought that audit could improve the quality of care; 292 collected practice activity data, though 143 of them did not use it. A total of 111 doctors recorded some outcome measures, though half of them did not use them. Varying proportions of doctors had registers, for various diseases (136 had at least one register), disease management policies (60 doctors), and prescribing policies. In all, 184 doctors met monthly with other members of the primary health care team.
Much poorly focused data collection is taking place. Some doctors have experience in setting up basic information systems and practice policies, and some audit is being performed. The family health services authorities need to take seriously the perceived difficulties of time, organisation, and resources concerned with audit.
确定全科医生对医疗审计的态度,并了解已经采取了哪些举措;明确未来的审计思路以及在基层医疗中实施审计所察觉到的困难。
对一份自行填写的邮政调查问卷的回复进行分析。
人口约75万的城市集聚区。
利兹家庭医生委员会普通医疗名单上的386名全科医生。
执业活动数据、结果指标和临床数据的记录程度、数据的使用情况以及所开展的审计;审计思路和察觉到的困难。
来自121家诊所的317名医生回复了问卷(个人回复率82%,诊所回复率88%)。总计206名医生认为审计能够提高医疗质量;292名医生收集了执业活动数据,但其中143名未加以使用。共有111名医生记录了一些结果指标,不过其中一半未使用这些指标。不同比例的医生拥有各类疾病的登记册(136名医生至少有一本登记册)、疾病管理政策(60名医生)和处方政策。总计184名医生每月与基层医疗团队的其他成员会面。
目前正在进行许多重点不明确的数据收集工作。一些医生具备建立基本信息系统和执业政策的经验,并且正在开展一些审计工作。家庭健康服务机构需要认真对待所察觉到的与审计相关的时间、组织和资源方面的困难。