engleski

DEVELOPMENT OF QUALITY INDICATORS IN GENERAL PRACTICE IN CROATIA

Several studies provided recently in Croatia were oriented towards defining frame for quality assessment in Croatian general practice. One qualitative study investigated patient perception of disease while other quantitative study try to get insight in patient enablement related to utilization of General Practice. This study represent combined qualitative and quantitative research of detect how previously defined instrument fit for quality assessment in different general practice settings. This feasibility study analyses reliability and acceptability of the Instrument for Quality Assessment in General Practice. Quality indicators related to the premises, medical equipment, phone call organisation, home visits, medical records, the patient satisfaction, preventive work, group work with chronic patients, complications of chronic diseases and early diagnosis of the diseases were rated reliable and acceptable. Quality indicators related to waiting time, practice size, scope of work, rational medication prescribing and diagnosis were rated reliable but with implementation issues. Doctors with longer professional experience, which show more interest toward continuous medical education, have better team coordination and wider networking shows as a predictor of high quality which is related to medical equipment, phone call organisation, medical documentation, the patient satisfaction, preventive work, application of medical technical procedures, rational prescribing and diagnosis. The predictors for better medical equipment and wider spectrum of application of medical technical procedures are distance to nearest hospital and rural sitting. Urban sitting is a predictor for rational medication prescription. Higher rate of patients under the age 19 on GP list of patients showed to be a predictor for higher rate of immunization. Higher rate of patients over the age 19 showed to be a predictor for early diagnosis of diseases. Testing of defined Instrument clearly showed that some indicators are appropriate for one type of practices and other indicators are appropriate for other type of practice. Specific results of the study will be used to improve existing quality assessment scheme in Croatian general practice.

General Practice; quality assessment; indicators; Croatia

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