title: Quality assessment of primary health care in a military setting.
abstract: OBJECTIVE
  The aim of this study was to analyze the quality of primary care in Israeli Defense Forces primary care clinics and physicians (PCPs) and to test the hypotheses that: (1) the quality of primary care provided in battalions is higher than that provided by other primary care providers and (2) the evaluation of a specific PCP within the framework of the quality assessment program results in an improved score during a second evaluation.
  
  
  METHODS
  Teams of two physicians carried out the control process. Each primary care clinic is evaluated in a standardized manner by filling a prospectively established form. Five parameters are examined: (1) direct inspection of the PCP, (2) medical record audit, (3) high-risk patients' management evaluation, (4) evaluation of secondary health care characteristics, and (5) medical staff guidance evaluation. The various clinics and physicians evaluated were classified as: battalion clinics, division and brigade clinics, training center clinics, and home-front clinics.
  
  
  RESULTS
  Between the years 1999 and 2001, 149 primary care clinics and 250 PCPs were evaluated. Seventy-four PCPs (29.6%) were evaluated twice. Battalion clinics scored higher than the other clinics. PCPs evaluated twice had significantly better quality assessment results at the second encounter.
  
  
  CONCLUSIONS
  Quality of primary health care is the highest in battalion troops clinics. We interpret the increase in quality assessment scores from one examination to the other as an index of improvement resulting from the feedback given to the providers.
authors.affiliation: Medicine Branch, Medical Corps, IDF, Israel. mandelrd@netvision.net.il
authors.forename: Dror
authors.initials: D
authors.lastname: Mandel
authors.forename: Eyal
authors.initials: E
authors.lastname: Zimlichman
authors.forename: Nachman
authors.initials: N
authors.lastname: Ash
authors.forename: Francis B
authors.initials: FB
authors.lastname: Mimouni
authors.forename: Yacov
authors.initials: Y
authors.lastname: Ezra
authors.forename: Yitshak
authors.initials: Y
authors.lastname: Kreiss
mesh_terms: D006801:Humans; D007557:Israel; D008485:Medical Audit; D008887:Military Medicine / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D015397:Program Evaluation; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods*; D012044:Regression Analysis