Hearnshaw H, Baker R, Cooper A
Eli Lilly National Clinical Audit Centre, Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital.
Br J Gen Pract. 1998 Feb;48(427):979-81.
Since 1991, all general practices have been encouraged to undertake clinical audit. Audit groups report that participation is high, and some local surveys have been undertaken, but no detailed national survey has been reported.
To determine audit activities in general practices and the perceptions of general practitioners (GPs) regarding the future of clinical audit in primary care.
A questionnaire on audit activities was sent to 707 practices from 18 medical audit advisory group areas. The audit groups had been ranked by annual funding from 1992 to 1995. Six groups were selected at random from the top, middle, and lowest thirds of this rank order.
A total of 428 (60.5%) usable responses were received. Overall, 346 (85%) responders reported 125.7 audits from the previous year with a median of three audits per practice. There was no correlation between the number of audits reported and the funding per GP for the medical audit advisory group. Of 997 audits described in detail, changes were reported as 'not needed' in 220 (22%), 'not made' in 142 (14%), 'made' in 439 (44%), and 'made and remeasured' in 196 (20%). Thus, 635 (64%) audits were reported to have led to changes. Some 853 (81%) of the topics identified were on clinical care. Responders made 242 (42%) positive comments on the future of clinical audit in primary care, and 152 (26%) negative views were recorded.
The level of audit activity in general practice is reasonably high, and most of the audits result in change. The number of audits per practice seems to be independent of the level of funding that the medical audit advisory group has received. Although there is room for improvement in the levels of effective audit activity in general practice, continued support by the professionally led audit groups could enable all practices to undertake effective audit that leads to improvement in patient care.
自1991年以来，一直鼓励所有全科医疗服务机构开展临床审计。审计小组报告称参与率很高，并且已经进行了一些地方调查，但尚未有详细的全国性调查报道。
确定全科医疗服务机构中的审计活动以及全科医生（GP）对基层医疗中临床审计未来的看法。
向来自18个医疗审计咨询小组区域的707家医疗服务机构发送了一份关于审计活动的问卷。这些审计小组根据1992年至1995年的年度资金进行了排名。从该排名顺序的上、中、下三分之一中随机选择了六个小组。
共收到428份（60.5%）可用回复。总体而言，346名（85%）回复者报告了上一年的125.7次审计，每家医疗服务机构的审计中位数为3次。报告的审计次数与医疗审计咨询小组每位全科医生的资金之间没有相关性。在详细描述的997次审计中，220次（22%）报告称无需改变，142次（14%）未进行改变，439次（44%）进行了改变，196次（20%）进行了改变并重新测量。因此，据报告635次（64%）审计导致了改变。确定的约853个（81%）主题与临床护理有关。回复者对基层医疗中临床审计的未来给出了242条（42%）积极评价，记录了152条（26%）负面看法。
全科医疗服务机构中的审计活动水平相当高，并且大多数审计都带来了改变。每家医疗服务机构的审计次数似乎与医疗审计咨询小组获得的资金水平无关。尽管全科医疗服务机构中有效审计活动的水平仍有提升空间，但由专业主导的审计小组持续提供支持可以使所有医疗服务机构开展有效的审计，从而改善患者护理。
