[Evaluation of a primary care self-management project]

Area of Science:

• Healthcare Management
• Primary Care Administration
• Public Health Policy

Background:

• Initiated in 1992, the Primary Care Self-Management Project aimed to decentralize budget control.
• The project involved nine Primary Care teams (PCT) in an urban setting in Vitoria-Gasteiz.
• A decentralized budget was allocated to each PCT, covering staff replacements and operational expenses.

Purpose of the Study:

• To evaluate the effectiveness of the Primary Care Self-Management Project.
• To assess the impact of self-management on cost control, professional motivation, and productivity within PCTs.

Main Methods:

• An observational and semi-experimental study design was employed.
• Various sub-designs were utilized, including post-test, pretest/post-test with one group, pre-test/post-test with a non-equivalent control group, and multiple temporal series.
• Data collection focused on budget adherence, absence from work rates, and replacement costs.

Main Results:

• Overall cost savings of 1.8% were achieved, with six out of nine PCTs meeting their assigned budgets.
• The Absence from Work index decreased by 31% in PCTs, indicating improved professional motivation compared to a stable index in other county staff.
• Productivity and budget utilization improved, evidenced by a 7.2% reduction in replacement costs and a significant decrease in the proportion of costs related to scheduled activity replacements.

Conclusions:

• Self-management initiatives within Primary Care teams can lead to significant cost control.
• The project demonstrated a positive impact on professional motivation and reduced absenteeism.
• The study concludes that self-management has beneficial effects on various operational aspects of Primary Care teams.