Medical Faculty, Philipps-University of Marburg, Karl-von-Frisch-Strasse 4, 35043 Marburg, Germany.
Department of Quality Assurance/Quality Management, Association of Statutory Health Insurance Physicians in Saxony, Schützenhöhe 12, 01099 Dresden, Germany.
Int J Environ Res Public Health. 2019 Feb 2;16(3):444. doi: 10.3390/ijerph16030444.
Since 1 January 2004, all physicians, psychotherapists, and medical care centers that are under contract to statutory healthcare in Germany are obliged, according to § 135a Section 2 of the Fifth Social Security Statute Book, to introduce an intra-institutional quality management system.
A total of 24 medical practices were chosen through random sampling. In total, there were 12 family physicians and specialist practices each and eight practices each per quality management system. The analysis was carried out with the help of three specially developed questionnaires (physician, employee, and patient). A total of 26 quality categories with different questions were available in the three survey groups (physicians, employees, and patients). The Kruskal⁻Wallis test checked the extent to which the different scores between the quality management systems were significant and effective for specialists or family physicians.
"Quality and Development in Practices (QEP)" had the highest average score. Due to a specific family practitioner specialism, "Quality management in Saxony medical practices (QisA)" followed with good average scores. The individual quality categories in the quality management systems, such as the "range of services" or "allocation of appointments", received the highest average scores among the specialists. In contrast, categories such as "telephone enquiries" and "external cooperation and communication" received the highest average scores among the family physicians.
Differences in the evaluation of quality management systems and medical groups (specialists/family physicians) were found in the study. The reasons for these differences could be found in the quality categories.
自 2004 年 1 月 1 日起，德国所有与法定医疗保健签约的医生、心理治疗师和医疗保健中心，均须按照《社会保障法》第 5 卷第 135a 条第 2 款的规定，引入机构内质量管理体系。
通过随机抽样选择了 24 家医疗实践机构。共有 12 家家庭医生和专科医生实践机构，每家各 8 家，每家都有质量管理体系。分析是在三个专门开发的问卷（医生、员工和患者）的帮助下进行的。在这三组调查对象（医生、员工和患者）中，共有 26 个不同问题的质量类别。Kruskal-Wallis 检验检查了不同质量管理体系之间的得分差异对专科医生或家庭医生的显著程度和有效性。
“实践中的质量和发展（QEP）”的平均得分最高。由于特定的家庭医生专业，“萨克森医疗实践中的质量管理（QisA）”紧随其后，平均得分也很好。质量管理系统中的个别质量类别，如“服务范围”或“预约分配”，在专科医生中获得了最高的平均得分。相比之下，“电话查询”和“外部合作与沟通”等类别在家庭医生中获得了最高的平均得分。
在这项研究中，发现了质量管理系统和医疗团体（专科医生/家庭医生）评估之间的差异。这些差异的原因可以在质量类别中找到。
