چکیده (انگلیسی):

Background:The aim of our study was to describe variability in process quality in family medicine among 31 European
countries plus Australia, New Zealand,and Canada. The quality of family medicine was measured in terms of continuity,
coordination, community orientation, and comprehensiveness of care.
Methods:The QUALICOPC study (Quality and Costs of Primary Care in Europe) was carried out among family physicians
in 31 European countries (the EU 27 except for France, plus Macedonia, Iceland, Norway, Switzerland, and Turkey) and
three non-European countries (Australia, Canada, and NewZealand). We used random sampling when national registers
of practitioners were available. Regional registers or lists of facilities were used for some countries.
A standardized questionnaire was distributed to the physicians, resulting in a sample of 6734 participants. Data collection
took place between October 2011 and December 2013. Based on completed questionnaires, a three-dimensional
framework was established to measure continuity, coordination, community orientation, and comprehensiveness of care.
Multilevel linear regression analysis was performed to evaluatethe variation of quality attributable to the family physician
level and the country level.
Results:None of the 34 countries in this study consistently scoredthe best or worst in all categories. Continuity of care
was perceived by family physicians as the most important dimension of quality. Some components of
comprehensiveness of care, including medical technical procedures, preventive care and health care promotion, varied
substantially between countries. Coordination of care was identified as the weakest part of quality. We found that
physician-level characteristics contributed to the majority of variation.
Conclusions:A comparison of process quality indicators in family medicine revealed similarities and differences within
and between countries. The researchersfound that the major proportion of variation can be explained by physicians’
characteristics.