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


METHODS
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.


METHODS
Sixty-two family practices across The Netherlands.


METHODS
Eight-hundred and forty consultations concerning non-acute abdominal complaints, first encounters.


METHODS
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.
van Berkestijn
L G
LG
Department of General Practice/Family Medicine, Universiteit Utrecht, The Netherlands. HAG-WO@med.ruu.nl
Kastein
M R
MR
Lodder
A
A
de Melker
R A
RA
Bartelink
M L
ML
D000005:Abdomen; D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D015986:Confounding Factors, Epidemiologic; D003248:Constipation / Q000209:etiology; D003697:Delphi Technique; D003967:Diarrhea / Q000209:etiology; D005194:Family Practice / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000592:standards