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强制性质量改进框架各组成部分的可接受性:瑞士全科医生调查

Acceptability of Components for a Mandatory Quality Improvement Framework: A Survey Among Swiss General Practitioners.

作者信息

Wirth David, Senn Oliver, Burgstaller Jakob M, Djalali Sima, Muheim Leander, Rohrbasser Adrian, Lehmann Joel, Markun Stefan

机构信息

Institute of Primary Care, University and University Hospital Zurich, Zurich, Switzerland.

Zollikerberg Hospital, Clinic for Internal Medicine/Interdisciplinary Emergency Ward and SGAIM Quality Commission, Zollikerberg, Switzerland.

出版信息

Health Serv Insights. 2025 Jun 21;18:11786329251346828. doi: 10.1177/11786329251346828. eCollection 2025.

Abstract

BACKGROUND

In Switzerland, recently introduced legislation requires the implementation of a framework for mandatory quality improvement at the level of individual general practitioners (GPs) and includes the introduction of quality indicators (QIs) amongst other components. The GP-sided acceptance of potential components of such a framework is important to its success.

OBJECTIVES

To identify components of a potential framework for mandatory quality improvement that are most likely to be accepted by Swiss GPs.

DESIGN

Cross-sectional web-based survey conducted among employed and self-employed Swiss GPs in 2024.

METHODS

The survey was distributed to 1103 Swiss GPs via their physician networks. The survey inquired the acceptability of 62 possible components of a mandatory framework for quality improvement. Components were categorized as "acceptable" if they were rated as "acceptable" or "very acceptable" by more than 50% of participants, in contrast to those rated as "neutral" or "not acceptable."

RESULTS

A total of 244 GPs participated (participation rate 22.1%, 53.0% male, 51.2% <50 years old, 50.8% employed). The majority of participants rated 31 of the proposed 62 components as acceptable. Among these were QIs pertaining to structures and processes of care (rated as acceptable by 58.3%-83.4%) and sharing QI achievement data with peers from different group practices and physician networks (53.9%-92.2%). A majority of participants accepted physician networks, medical associations, and academic institutions as entities that could establish QIs and manage QI data (acceptance 62.1%-88.8%).

CONCLUSIONS

Swiss GPs appear to accept QIs that reflect structures and processes of care established by physician networks, medical associations or academic institutions, exclusively shared among their peers.

摘要

背景

在瑞士,最近出台的立法要求在个体全科医生(GP)层面实施强制性质量改进框架,其中包括引入质量指标(QI)等其他组成部分。全科医生对该框架潜在组成部分的接受程度对其成功实施至关重要。

目的

确定最有可能被瑞士全科医生接受的强制性质量改进潜在框架的组成部分。

设计

2024年对受雇和自营的瑞士全科医生进行基于网络的横断面调查。

方法

通过其医生网络向1103名瑞士全科医生分发调查问卷。该调查询问了质量改进强制性框架62个可能组成部分的可接受性。如果超过50%的参与者将其评为“可接受”或“非常可接受”,则这些组成部分被归类为“可接受”,与评为“中立”或“不可接受”的组成部分形成对比。

结果

共有244名全科医生参与(参与率22.1%,男性占53.0%,50岁以下占51.2%,受雇占50.8%)。大多数参与者将提议的62个组成部分中的31个评为可接受。其中包括与护理结构和流程相关的质量指标(评为可接受的比例为58.3%-83.4%),以及与来自不同团体执业和医生网络的同行分享质量改进成果数据(53.9%-92.2%)。大多数参与者接受医生网络、医学协会和学术机构作为可以制定质量指标和管理质量改进数据的实体(接受率为62.1%-88.8%)。

结论

瑞士全科医生似乎接受由医生网络、医学协会或学术机构制定的、仅在同行之间共享的、反映护理结构和流程的质量指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfc/12182608/7693716157c7/10.1177_11786329251346828-fig1.jpg

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