[Delphi study of Palmer's quality method in primary care: strong and weak points and areas of utilization]

To identify the strong and weak points of Palmer's Quality Method as it applies to Primary Care (PC), and determine the areas of quality assurance to which it is most suited.

Delphi Study.

Primary Care-related professionals, homogeneously distributed throughout the different autonomous communities.

52 assurance experts selected on the basis of their publications, and from lists provided by well known, prestigious experts.

Each expert was first contacted by phone to request participation in the study. The first questionnaire that was sent asked the participants to respond to the following questions: "Which are, in your judgement, the positive aspects (strong points) and negative aspects (weak points) of Palmer's Quality Method with regard to PC?" and "In which quality assurance area do you think its use is most effective?"

Respondents to the first questionnaire (35 experts) listed 125 strong points, 111 weak points and 52 areas. After similar responses were grouped together, the resulting totals were 67 strong points, 40 weak points and 11 areas. The second questionnaire was rated by 32 experts. The third questionnaire was then created using the 7 highest-scoring answers, including the average score and scoring variance for each question. Thirty-one experts responded. Ultimately, 8 strong points, 7 weak points and 7 areas of quality assurance were obtained.

Palmer's method continues to be useful in quality assurance work in PC. We believe that this study can serve to facilitate its use and suggest those situations where its use is most effective.