[Acceptance of lot sampling: its applicability to the evaluation of the primary care services portfolio].
OBJECTIVE
To determine the applicability of the acceptance of lot quality assurance sampling (LQAS) in the primary care service portfolio, comparing its results with those given by classic evaluation.


METHODS
Compliance with the minimum technical norms (MTN) of the service of diabetic care was evaluated through the classic methodology (confidence 95%, accuracy 5%, representativeness of area, sample of 376 histories) and by LQAS (confidence 95%, power 80%, representativeness of primary care team (PCT), defining a lot by MTN and PCT, sample of 13 histories/PCT). Effort, information obtained and its operative nature were assessed.


METHODS
44 PCTs from Murcia Primary Care Region.


RESULTS
Classic methodology: compliance with MTN ranged between 91.1% (diagnosis, 95% CI, 84.2-94.0) and 30% (repercussion in viscera, 95% CI, 25.4-34.6). Objectives in three MTN were reached (diagnosis, history and EKG). LQAS: no MTN was accepted in all the PCTs, <<01-diagnosis>> being the most accepted (42 PCT, 95.6%) and <<07-Funduscopy>> the least accepted (24 PCT, 55.6%). In 9 PCT all were accepted (20.4%), and in 2 none were accepted (4.5%). Data were analysed through Pareto charts.


CONCLUSIONS
Classic methodology offered accurate results, but did not identify which centres were those that did not comply (general focus). LQAS was preferable for evaluating MTN and probably coverage because: 1) it uses small samples, which foment internal quality-improvement initiatives; 2) it is easy and rapid to execute; 3) it identifies the PCT and criteria where there is an opportunity for improvement (specific focus), and 4) it can be used operatively for monitoring.
López-Picazo Ferrer
J
J
Unidad de Calidad. Gerencia de Atención Primaria de Murcia. INSALUD.
D003920:Diabetes Mellitus / Q000628:therapy*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012494:Sampling Studies; D013030:Spain