Ahnfeldt-Mollerup Peder, Søndergaard Jens, Barwell Fred, Mazelan Patti M, Spurgeon Peter, Kristensen Troels
Research Unit for General Practice, Department of Public Health (Drs Ahnfeldt-Mollerup, Søndergaard, and Kristensen), and COHERE, Department of Business and Economics (Dr Kristensen), University of Southern Denmark, Odense, Denmark; Applied Research Ltd, Warley, West Midlands, United Kingdom (Drs Barwell and Mazelan); Institute of Clinical Leadership, Warwick Medical School, University of Warwick, Coventry, United Kingdom (Dr Spurgeon).
Qual Manag Health Care. 2018 Oct/Dec;27(4):191-198. doi: 10.1097/QMH.0000000000000188.
There is a limited knowledge on how medical engagement influences quality of care provided in primary care. The extent of the use of feedback reports from a national quality-of-care database can be considered as a measure of process quality. This study explores relationships between the use of feedback reports and medical engagement among general practitioners, general practitioner demographics, clinic characteristics, and services.
A cross-sectional combined questionnaire and register study in a sample of 352 single-handed general practitioners in 2013. Logistic regression analysis was used to explore associations between the use of feedback reports for diabetes and chronic obstructive pulmonary disease and medical engagement.
For both diabetes and chronic obstructive pulmonary disease, a higher degree of medical engagement was associated with an increased use of feedback reports. Furthermore, we identified positive associations between using feedback reports and general practitioner services (spirometry, influenza vaccinations, performing annual reviews for patients with chronic diseases) and a negative association between usage of quality-of-care feedback reports and the number of consultations per patient.
Using feedback reports for chronic diseases in general practice was positively associated with medical engagement and also with the provision of services in general practice.
关于医疗参与如何影响初级保健中所提供护理的质量，人们了解有限。使用来自国家护理质量数据库的反馈报告的程度可被视为过程质量的一项衡量指标。本研究探讨了反馈报告的使用与全科医生的医疗参与、全科医生人口统计学特征、诊所特征及服务之间的关系。
2013年对352名单科执业全科医生样本进行了一项横断面问卷调查与登记研究。采用逻辑回归分析来探究糖尿病和慢性阻塞性肺疾病反馈报告的使用与医疗参与之间的关联。
对于糖尿病和慢性阻塞性肺疾病，更高程度的医疗参与都与反馈报告使用的增加相关。此外，我们发现使用反馈报告与全科医生服务（肺活量测定、流感疫苗接种、为慢性病患者进行年度复查）之间存在正相关，而护理质量反馈报告的使用与每位患者的会诊次数之间存在负相关。
在全科医疗中使用慢性病反馈报告与医疗参与以及全科医疗服务的提供呈正相关。
