Tušek-Bunc Ksenija, Petek Davorina
Faculty of Medicine, University of Maribor, Taborska ulica 8, Maribor, Slovenia.
Dr Adolf Drolc Health Centre Maribor, Ul. talcev 9, Maribor, Slovenia.
Int J Qual Health Care. 2018 Aug 1;30(7):551-557. doi: 10.1093/intqhc/mzy071.
Family medicine plays an important role in quality of care (QoC) of coronary heart disease (CHD) patients. This study's aim was to determine the quality of secondary cardiovascular disease prevention in the everyday practice of family physicians.
This study was observational cross-sectional.
About 36 randomly selected family medicine practices stratified by size and location in Slovenia.
CHD patients randomly selected from a patient register available in family medicine practices.
MAIN OUTCOME MEASURE(S): The instrument for assessment of quality included a form for collecting data from medical records, a general practice assessment questionnaire and a patient questionnaire. QoC was defined by two composite variables, namely risk factor registration and CHD patient process of care, as the two care outcomes. In multivariate analysis, we performed multilevel regression analysis to identify the associations between QoC, the patient and the practice characteristics.
The final sample included 423 CHD patients from 36 family medicine practices. Risk factor registration was associated with the practice organisation score (P = 0.004), practice size (P = 0.042), presence of comorbid atherosclerotic diseases (P = 0.043) and a lower age of CHD patients (P = 0.001). CHD patient process of care was associated with the practice organisation score (0.045) and a lower age of CHD patients (P = 0.035).
The most important factors affecting the quality of CHD patient care were linked to the organisational characteristics of the family medicine practices.
家庭医学在冠心病（CHD）患者的医疗质量（QoC）中发挥着重要作用。本研究的目的是确定家庭医生日常实践中二级心血管疾病预防的质量。
本研究为观察性横断面研究。
在斯洛文尼亚，按规模和地理位置随机选取约36家家庭医学诊所。
从家庭医学诊所可用的患者登记册中随机选取的冠心病患者。
质量评估工具包括一份用于从病历中收集数据的表格、一份全科医疗评估问卷和一份患者问卷。医疗质量由两个复合变量定义，即危险因素登记和冠心病患者护理过程，作为两个护理结果。在多变量分析中，我们进行了多层次回归分析，以确定医疗质量、患者和诊所特征之间的关联。
最终样本包括来自36家家庭医学诊所的423名冠心病患者。危险因素登记与诊所组织得分（P = 0.004）、诊所规模（P = 0.042）、合并动脉粥样硬化疾病的存在（P = 0.043）以及冠心病患者年龄较低（P = 0.001）相关。冠心病患者护理过程与诊所组织得分（P = 0.045）以及冠心病患者年龄较低（P = 0.035）相关。
影响冠心病患者护理质量的最重要因素与家庭医学诊所的组织特征有关。
