Developing a 'consultation quality index' (CQI) for use in general practice.

Area of Science:

• General Practice
• Healthcare Quality Assessment
• Primary Care Research

Background:

• Core values of general practice, holism and patient-centredness, are not captured by current quality of care measures.
• Existing quality of care metrics in general practice fail to reflect essential values like patient-centredness during routine consultations.

Purpose of the Study:

• To construct a "Consultation Quality Index" (CQI) that quantifies the core values of general practice.
• Utilize "consultation length," patient "knowledge of the doctor," and "patient enablement" as key components for the CQI.
• Develop a comprehensive measure reflecting both process and outcome indicators of quality in general practice.

Main Methods:

• The CQI was developed using data from 23,799 patients and 221 doctors across diverse UK regions.
• 171 doctors were scored based on three variables: consultation length, patient knowledge of doctor, and patient enablement.
• A total CQI score was calculated for each doctor based on these weighted components.

Main Results:

• CQI scores ranged from 4 to 18, demonstrating a quantifiable measure of consultation quality.
• The CQI exhibited strong face validity and was independent of patient case mix and practice deprivation scores.
• Higher CQI scores were significantly associated with smaller general practice list sizes.

Conclusions:

• The developed CQI offers a potential tool for assessing the quality of care provided by general practitioners and practices.
• The CQI may assist in identifying underperforming doctors and could inform incentive schemes for rewarding effective consulting.
• Further research is planned to validate CQI scores against routine National Health Service (NHS) performance indicators.