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Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study
Katja Goetz1, Sigrid Hess2, Marianne Jossen2
1Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany.
Objectives:
To examine the effectiveness of the quality management programme--European Practice Assessment--in primary care in Switzerland.
Design:
Longitudinal study with three points of measurement.
Setting:
Primary care practices in Switzerland.
Participants:
In total, 45 of 91 primary care practices completed European Practice Assessment three times.
Outcomes:
The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: 'infrastructure', 'information', 'finance', and 'quality and safety' to examine changes over time.
Results:
Significant improvements were found in three of four domains: 'quality and safety' (F=22.81, p<0.01), 'information' (F=27.901, p<0.01) and 'finance' (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01).
Conclusions:
The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care.
