New paradigms for quality in primary care.
Year: 2001
Type: article
Abstract: HERE is no longer any doubt of the importance of primary care as the key to an effective and efficient health service. Primary care, defined in terms of the achievement of its four functions, can be measured and its quality assessed. But, as in all forms of human endeavour, science and society change over time, providing primary care with new challenges. The science of quality measurement is, at best, still in its adolescence. 1 For the most part, current approaches to assessing quality of care are based on models developed a half-century ago. At that time, the techniques of medical audit of the processes of care were developed to assess the extent to which generally recognised features of care, such as preventive procedures, indicated screening tests, and appropriate management strategies for specific conditions, were performed by practitioners. These are still the stock-intrade of virtually all quality assessment schemes today with relatively minor modification. First, evidence for appropriateness is increasingly sought as the basis for making judgments about indicated interventions. Secondly, satisfaction surveys have been added to the armamentarium of quality assessments, although these types of assessments are arguably more useful for marketing of competing health plans than for assessing the quality of care. Outcomes of care, as characterised by self-reported functional assessment instruments, are increasingly recognised as important measures of quality; however, there have been no serious
Source: Europe PMC (PubMed Central)
Author: B Starfield
Institution: Johns Hopkins University
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1821029068