Department for Quality Measurement and Patient Safety, Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
BMC Health Serv Res. 2010 Apr 30;10:108. doi: 10.1186/1472-6963-10-108.
Instruments have been developed to assess professional views of the quality of care but have rarely been tested for responsiveness to change. The objective of this study was to test the responsiveness of the General Practitioner Experiences Questionnaire (GPEQ) for the measurement of Community Mental Health Centres in Norway.
National surveys were conducted in Norway in 2006 (n = 2,415) and 2008 (n = 2,209) to measure general practitioners' evaluation of community mental health centres. GPs evaluated the centres by means of a postal questionnaire, consisting of questions focused on centre quality and cooperation with GPs. As part of the national surveys 75 GPs in 2006 and 66 GPs in 2008 evaluated Hamar community mental health centre. Between the surveys, several quality improvement initiatives were implemented which were directed at cooperation with and guidance for GPs in Stange municipality, one of eight municipalities in Hamar centre catchment area. The main outcome measures were changes in GPEQ scores from 2006 to 2008 for GPs evaluating Hamar community mental health centre from Stange municipality, and changes in scores for GPs in the other seven municipalities and nationally which were assessed for statistical significance.
GPs in Stange municipality rated Hamar community mental health centre significantly better on the guidance scale in 2008 than in 2006; on a 0-100 scale where 100 represents the best possible experiences the score was 26.5 in 2006 and 58.3 in 2008 (p < 0.001). Apart from one item about workforce situation, none of the other scales and items showed significant changes. The control group from the other seven municipalities gave significantly poorer rating for the emergency situation scale, the workforce situation scale and seven items in 2008 than in 2006. The national results showed small differences between 2006 and 2008, even though several scales and items were significantly different. A question about changes in centre performance over the last 2-3 years showed that 82% of GPs from Stange municipality reported that Hamar community mental health centre had improved, compared to only 36% from the other seven municipalities and 40% nationally which was statistically significant.
Following the implementation of an initiative designed to enhance service quality, the GPEQ identified expected changes in the guidance scale for the intervention group, indicating that the instrument is responsive to change. The worsening of services for GPs in the control group evaluating Hamar centre warrants further study.
已经开发出一些工具来评估专业人员对医疗服务质量的看法，但这些工具很少被测试其对变化的敏感性。本研究的目的是测试一般从业者经验问卷（GPEQ）对挪威社区心理健康中心的测量的反应能力。
2006 年（n=2415）和 2008 年（n=2209）在挪威进行了全国性调查，以衡量全科医生对社区心理健康中心的评价。全科医生通过邮寄问卷对中心进行评估，问卷内容集中在中心质量和与全科医生的合作。作为全国性调查的一部分，2006 年有 75 名全科医生和 2008 年有 66 名全科医生对哈马尔社区心理健康中心进行了评估。在调查之间，实施了多项质量改进举措，旨在加强与哈马尔中心服务区的 8 个市之一的斯坦格市的全科医生的合作，并为他们提供指导。主要结局指标为 2006 年至 2008 年期间评估斯坦格市哈马尔社区心理健康中心的全科医生的 GPEQ 评分变化，以及评估其他七个市和全国范围内全科医生的评分变化，评估其统计显著性。
2008 年，斯坦格市的全科医生在指导量表上对哈马尔社区心理健康中心的评价明显优于 2006 年；在 0-100 分制中，100 分代表最佳体验，2006 年得分为 26.5，2008 年得分为 58.3（p<0.001）。除了一项关于劳动力情况的项目外，其他量表和项目均无显著变化。来自其他七个市的对照组在 2008 年对紧急情况量表、劳动力情况量表和七个项目的评分明显低于 2006 年。全国范围内的结果显示，2006 年至 2008 年之间存在细微差异，尽管几个量表和项目存在显著差异。关于过去 2-3 年中心绩效变化的问题显示，82%的斯坦格市全科医生表示哈马尔社区心理健康中心有所改善，而其他七个市和全国范围内的比例仅为 36%和 40%，这具有统计学意义。
在实施旨在提高服务质量的举措后，GPEQ 确定了干预组指导量表的预期变化，表明该工具对变化敏感。对评估哈马尔中心的对照组中全科医生服务质量的恶化需要进一步研究。
