MEASURING GENERAL PRACTICE A demonstration project to develop and test a set of primary care clinical quality indicators National Primary Care Research and Development Centre, University of Manchester RAND, Santa Monica, CA, USA
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MEASURING GENERAL PRACTICE A demonstration project to develop and test a set of primary care clinical quality indicators
Professors of General Practice Martin N. Marshall Martin O. Roland Research Fellows Stephen M. Campbell Sue Kirk, David Reeves National Primary Care Research and Development Centre, Williamson Building University of Manchester, Oxford Road, Manchester M13 9PL, UK
Vice President, RAND; Director, RAND Health Professor of Medicine and Health Services, UCLA Robert Brook Associate Director RAND Health Elizabeth A. McGlynn Senior Scientist Paul G. Shekelle RAND Health, Main Street, Santa Monica, CA, USA
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Library of Congress Cataloging-in-Publication Data Measuring general practice : a demonstration project to develop and test a set of primary care clinical quality indicators / Martin N. Marshall ... [et al.]. p. cm. “MR-1725.” Includes bibliographical references. ISBN 0-8330-3425-1 (pbk.) 1. Primary care (Medicine)—Great Britain—Evaluation. [DNLM: 1. Primary Health Care. 2. Quality Indicators, Health Care. 3. Family Practice. W 84.6 M484 2003] I. Marshall, Martin (Martin N.) II. Rand Corporation. RA399.G7M43 2003 362.1'068'5—dc21 2003010698
ISBN 0-8330-3425-1 © The Nuffield Trust, 2003
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CONTENTS
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Executive summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Chapter 1
The policy context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Chapter 2
Quality indicators for primary care: an overview . . . . . . . . . . . . . . . . . . . . . . . . 13
Chapter 3
Aims and objectives of the project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Chapter 4
Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 (i) Indicator development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 (ii) The demonstration project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Chapter 5
Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 (i) The indica