title: Testing a European set of indicators for the evaluation of the management of primary care practices.
abstract: BACKGROUND
  Effective practice management is an important prerequisite for offering good clinical care. Internationally valid, reliable and feasible indicators and instruments are needed to describe and compare the management of primary care practices in Europe.
  
  
  OBJECTIVE
  This paper describes development and evaluation of the European Practice Assessment instrument and indicators (Engels Y, Campbell S, Dautzenberg M et al. Developing a framework of, and quality indicators for, general practice management in Europe. Fam Pract 2005; 22(2): 215-22).
  
  
  METHODS
  The study design was a validation and feasibility study set in 273 general practices in Austria, Belgium, France, Germany, Israel, The Netherlands, Slovenia, Switzerland and the UK. Use was made of a set of 62 valid quality indicators derived previously from an international Delphi procedure. The EPA instrument, based on this set of indicators, was used to collect data in the 273 practices. This instrument consists of self-completed questionnaires for doctors, staff managers and patients. In addition, there is an interview schedule for use by an outreach visitor, to be held with the lead GP or manager, and a visitor checklist. The instrument was analysed using expert review by the project partners, factor and reliability analyses, ANOVA analyses and by determining intraclass correlations.
  
  
  RESULTS
  Fifty-seven indicators were found to be valid, feasible, reliable and discriminative in all participating countries. The instrument was able to determine differences in practice management within and between countries. All (but one) practices completed the assessment procedure. The data collection method appeared to be feasible, although some aspects can be improved.
  
  
  CONCLUSIONS
  The EPA instrument provides feedback to practices that facilitates quality improvement and can compare primary care practices on a national and an international level.
authors.affiliation: National Primary Care Research and Development Centre, University of Manchester, UK. y.engels@kwazo.umcn.nl
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Engels
authors.forename: Maaike
authors.initials: M
authors.lastname: Dautzenberg
authors.forename: Stephen
authors.initials: S
authors.lastname: Campbell
authors.forename: Björn
authors.initials: B
authors.lastname: Broge
authors.forename: Nicole
authors.initials: N
authors.lastname: Boffin
authors.forename: Martin
authors.initials: M
authors.lastname: Marshall
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
authors.forename: Vlasta
authors.initials: V
authors.lastname: Vodopivec-Jamsek
authors.forename: Ferdinand M
authors.initials: FM
authors.lastname: Gerlach
authors.forename: Marianne
authors.initials: M
authors.lastname: Samuelson
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
mesh_terms: D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D011216:Practice Management, Medical / Q000592:standards*; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care / Q000592:standards*; D012307:Risk Factors; D017749:Total Quality Management