Patients' own assessments of quality of primary care compared with objective records based measures of technical quality of care: cross sectional study
Patients' own assessments of quality of primary care compared with objective records based measures of technical quality of care: cross sectional study
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DOI：
10.1136/bmj.38874.499167.7c
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发表时间：
2006-07-01
影响因子：
105.7
通讯作者：
Hammersley, Richard
中科院分区：
文献类型：
--
作者：
Rao, Mala;Clarke, Aileen;Hammersley, Richard
目的探讨老年患者对初级保健质量的评价与良好临床实践措施之间的关系，采用全科医学评价调查方法，以英国南部Basildon初级保健信托区的18家全科医学机构为研究对象，设计横断面人群研究。研究对象为3487名65岁以上的老年人。主要结果测量全科医学评估调查的平均实践得分与病例记录调查的三项循证措施之间的相关性（监测和控制高血压，和接种流感疫苗）。（3487/4563）对一般实践评估调查作出了回应，患者评估的技术质量调查评分与基于客观记录的良好临床实践措施之间的相关性为0.22（95%可信区间-0.28至0.62），高血压控制为0.30（-0.19至0.67），流感疫苗接种为-0.05（-0.50至0.43）。对于总体评估，需要基于患者和基于记录的措施。
Objective To investigate the relation between older patients' assessments of the quality of their primary care and measures of good clinical practice on the basis of data from administrative and clinical records.Design Cross sectional population based study using the general practice assessment survey.Setting 18 general practices hi the Basildon primary care trust area, south cast England. Participants 3487 people aged 65 or more.Main outcome measures Correlations between mean practice scores on the general practice assessment survey and three evidence based measures on survey of case records (monitoring for, and control of, hypertension, and vaccination against influenza).Results 76% of people (3487/4563) responded to the general practice assessment surveys Correlations between patient assessed survey scores for technical quality and the objective records based measures of good clinical practice were 0.22 (95% confidence interval - 0.28 to 0.62) for hypertension monitored, 0.30 (- 0.19 to 0.67) for hypertension controlled, and - 0.05 (- 0.50 to 0.43) for influenza vaccination.Conclusions Older patients' assessments are not a sufficient basis for assessing die technical quality of their primary care. For an overall assessment it both patient based and records based measures are required.