Ministry of Health, Muscat, Oman.
University of KwaZulu Natal, Durban, KwaZulu-Natal, South Africa.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720946953. doi: 10.1177/2150132720946953.
Effective primary health care (PHC) is the key to attaining universal health coverage. The key performance indicators (KPIs), is a component of quality improvement in the PHC service sector that provides feedback to inform and better public service delivery and promoting accountability. We assessed the current performance of PHC service by using KPIs to identify the possible challenges that necessitate being confronted, highlight the lessons learnt, and propose steps towards improvements.
We conducted a cross-sectional observational study across 12 PHC centers in 6 governorates in Oman during the period of June 2017 to June 2018. Secondary data from the computerized medical records of the PHC centers on six key indicators, accessibility, workload, outcomes, timeliness, satisfaction, and safety were analysed to assess the performance of PHC service and to identify challenges confronted and propose steps towards further service improvement.
The mean overall KPIs scores across the ten PHC centers were 174.5 (SD: 9.80) or 67.01%. The overall scores were normally distributed with a median score of 175 (IQR: 171-181). The lowest percentage score was obtained by Al Qabil (61.35%) with the highest mark being at Wadi Kabir (70.54%). The mean score across all KPIs was 3.84 (SD:0.94) with a median score of 3.9 (IQR: 3.43-4.5). Of the six KPI components, safety (4.85), satisfaction (4.67), timeliness (4.44), and accessibility (4.31) had the highest performance scores, whilst workload (4.15) and outcomes (3.75) lagged behind.
Performance across the KPIs exhibited a considerable variation between facilities, with workload and outcome performing lower than other components. The findings of this study offered a measure of internal strengths that need to be sustained, challenges that require quality improvement initiatives, and external factors such as social determinants that impact overall performance PHC.
有效的初级卫生保健（PHC）是实现全民健康覆盖的关键。关键绩效指标（KPI）是 PHC 服务部门质量改进的组成部分，可提供反馈信息，改善公共服务提供并促进问责制。我们使用 KPI 评估 PHC 服务的当前绩效，以确定需要应对的挑战，突出经验教训，并提出改进措施。
我们在 2017 年 6 月至 2018 年 6 月期间在阿曼的 6 个省的 12 个 PHC 中心进行了一项横断面观察性研究。对 PHC 中心计算机化医疗记录中的六个关键指标（可及性、工作量、结果、及时性、满意度和安全性）的次要数据进行了分析，以评估 PHC 服务的绩效，并确定面临的挑战，提出进一步改进服务的步骤。
十个 PHC 中心的平均总体 KPI 得分为 174.5（SD：9.80）或 67.01％。总体得分呈正态分布，中位数为 175（IQR：171-181）。Al Qabil 的得分最低（61.35％），Wadi Kabir 的得分最高（70.54％）。所有 KPI 的平均得分为 3.84（SD：0.94），中位数为 3.9（IQR：3.43-4.5）。在六个 KPI 组成部分中，安全性（4.85）、满意度（4.67）、及时性（4.44）和可及性（4.31）的绩效得分最高，而工作量（4.15）和结果（3.75）则落后。
KPI 之间的绩效在设施之间表现出相当大的差异，工作量和结果的表现低于其他组成部分。本研究的结果提供了衡量内部优势的指标，这些优势需要保持，还提供了需要质量改进举措的挑战，以及影响 PHC 整体绩效的外部因素，如社会决定因素。
