How well are patients treated in family practice? Quality of consultations for non-acute abdominal complaints

• Published in: International journal for quality in health care Vol. 10; no. 3; pp. 221 - 233
• Main Authors: van Berkestijn, Luc G. M., Kastein, Marcel R., Lodder, Aart, de Melker, Ruut A, Bartelink, Marie-Louise
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.06.1998; OXFORD UNIVERSITY PRESS
• Subjects: Abdomen; abdominal complaints; Abdominal Pain - etiology; Adolescent; Adult; Aged; Confounding Factors (Epidemiology); Constipation - etiology; Delphi Technique; Diarrhea - etiology; family doctor performance; Family Practice - standards; Female; Humans; Male; Middle Aged; Netherlands; Patient Satisfaction - statistics & numerical data; Prospective Studies; quality; Quality Assurance, Health Care; Referral and Consultation - standards; review criteria; Netherlands
• ISSN: 1353-4505; 1464-3677
• DOI: 10.1093/intqhc/10.3.221

Objective. To describe the application of weighted review criteria, developed by the Delphi technique, for the assessment of the quality of consultations concerning non-acute, abdominal complaints. Design. Descriptive study in two parts: (i) comparison of actual family doctor (FD)-performance with predefined review criteria; (ii) calculation of quality scores per consultation, utilizing the weighted criteria. Setting. Sixty-two family practices across The Netherlands. Subjects. Eight-hundred and forty consultations concerning non-acute abdominal complaints, first encounters. Main outcome measures. The percentage of consultations in which each criterion was met; quality scores per consultation and their distribution. Results. (i) Little effort was made to trace risk groups for gastrointestinal malignancies (<50% of the consultations concerned); medication was often described without dietary advice (17%); inappropriate activities were not carried out on a large scale (6%). (ii) Quality scores were normally distributed. Conclusions. The Delphi technique yields a useful instrument for assessment of the quality of consultations. The review criteria for quality assessment of FD performance used in this study made it possible to distinguish quite clearly between high- and low-quality consultations. Some important deficiencies in daily practice emerged.