title: [Benchmarking in ambulatory care practices--The European Practice Assessment (EPA)].
abstract: The European Practice Assessment (EPA) is a comprehensive quality management which consists of 220 indicators covering 5 domains (infrastructure, people, information, finance, and quality and safety). The aim of the project presented was to evaluate EPA as an instrument for benchmarking in ambulatory care practices. A before-and-after design with a comparison group was chosen. One hundred and two practices conducted EPA at baseline (t1) and at the 3-year follow-up (t2). A further 209 practices began EPA at t2 (comparison group). Since both practice groups differed in several variables (age of GP, location and size of practice), a matched-pair design based on propensity scores was applied leading to a subgroup of 102 comparable practices (out of the 209 practices). Data analysis was carried out using Z scores of the EPA domains. The results showed significant improvements in all domains between t1 and t2 as well as between the comparison group and t2. Furthermore, the results demonstrate that the implementation of total quality management and the re-assessment of the EPA procedure can lead to significant improvements in almost all domains.
authors.affiliation: Abteilung Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg. joachim.szecsenyi@med.uni-heidelberg.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Szecsenyi
authors.forename: Björn
authors.initials: B
authors.lastname: Broge
authors.forename: Sara
authors.initials: S
authors.lastname: Willms
authors.forename: Marc
authors.initials: M
authors.lastname: Brodowski
authors.forename: Katja
authors.initials: K
authors.lastname: Götz
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration / Q000592:standards*; D019985:Benchmarking / Q000458:organization & administration / Q000592:standards*; D005060:Europe; D005260:Female; D005858:Germany; D006284:Health Plan Implementation / Q000458:organization & administration / Q000592:standards; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009313:National Health Programs; D011785:Quality Assurance, Health Care / Q000458:organization & administration / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000458:organization & administration / Q000592:standards*; D017749:Total Quality Management / Q000458:organization & administration / Q000592:standards*