Quality assurance in primary medical care. 1983

P Kekki

Some general ideas of the evaluation of the work of the physician applicable also to primary care physicians are taken up in this article. The presentation is not trying to be a complete review of the topic. It tries, however, to direct attention to the importance of the subject from the point of view of the practising physician and also to point out some ideas of the possible difficulties to be faced in connection with primary medical care. Certain basic weaknesses of the original audit method in the primary setting are indicated. The usefulness of the structure-process-outcome model and of the understanding of the complex interactions and relationships between the various components of this model are stressed. Finally, a couple of promising methods relating to the work of the primary care physician are described. From the practice point of view the basic problem is to decide to what extent either the process or outcome are valid indicators of quality. Here one should keep in mind that correlation between these two measurements may be low and that it has been expressed by some (1) that, fundamentally, validity depends on the strength of the relationship between process and outcome and on our understanding of that relationship.

UI MeSH Term Description Entries
D008485 Medical Audit A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care. Audit, Medical,Audits, Medical,Medical Audits
D008499 Medical Records Recording of pertinent information concerning patient's illness or illnesses. Health Diaries,Medical Transcription,Records, Medical,Transcription, Medical,Diaries, Health,Diary, Health,Health Diary,Medical Record,Medical Transcriptions,Record, Medical,Transcriptions, Medical
D010043 Outcome and Process Assessment, Health Care Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically. Outcome and Process Assessment (Health Care),Donabedian Model,Donabedian Triad,Outcome and Process Assessment,Structure Process Outcome Triad,Model, Donabedian,Triad, Donabedian
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D011785 Quality Assurance, Health Care Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps. Quality Assessment, Health Care,Health Care Quality Assessment,Health Care Quality Assurance,Healthcare Quality Assessment,Healthcare Quality Assurance,Quality Assessment, Healthcare,Quality Assurance, Healthcare,Assessment, Healthcare Quality,Assessments, Healthcare Quality,Assurance, Healthcare Quality,Assurances, Healthcare Quality,Healthcare Quality Assessments,Healthcare Quality Assurances,Quality Assessments, Healthcare,Quality Assurances, Healthcare
D005387 Finland A country in northern Europe, bordering the Baltic Sea, Gulf of Bothnia, and Gulf of Finland, between Sweden and Russia. The capital is Helsinki. Aland Islands,Ă…land Islands
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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