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Measuring quality in general practice. Pilot study of a needs, process and outcome measure
J G Howie1, D J Heaney, M Maxwell
1Department of General Practice, University of Edinburgh.
Occasional Paper (Royal College of General Practitioners)
|February 1, 1997
Summary
Longer general practice consultations correlate with increased patient enablement, regardless of problem complexity. This suggests consultation time is a key indicator of quality care, benefiting patients across various health needs.
Area of Science:
- General Practice
- Healthcare Quality Assessment
- Patient-Centered Care
Background:
- The Scottish Shadow Fundholding Evaluation (1990-92) assessed quality of care in general practice.
- Previous work established consultation length as a proxy for quality and developed patient enablement measures.
Purpose of the Study:
- To analyze secondary data from the Scottish Shadow Fundholding Evaluation.
- To explore the generalizability of quality of care assessment methods beyond specific clinical problems.
Main Methods:
- Utilized a dataset including pre-consultation health needs questionnaires, consultation length, and post-consultation patient enablement scores.
- Conducted secondary analysis at population, practice, and doctor levels.
Main Results:
- Strong positive correlations were found between consultation length and patient enablement across psychological, social, and physical problems.
- Practices and doctors spending more time in consultations demonstrated higher patient enablement.
- Doctors with longer consultations were more likely to be patient-centered.
Conclusions:
- Consultation length and patient enablement scores can serve as reliable summary statistics for general practice quality.
- The methods developed offer valuable insights into defining and delivering quality care.
- Further testing in diverse settings and comparison with routine NHS data is recommended.
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