ASSESSMENT OF PATIENTS' HEALTH STATUS IN FAMILY MEDICINE
General Practitioners feel increasing pressure from Public Health authorities to evaluate their work but generally accept outcome indices such as morbidity and mortality are too far away from GP practices to allow direct evaluative conclusions. A simple instrument is needed to assess the evolution i...
Published in: | International Journal for Quality in Health Care |
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Main Authors: | , , , , |
Format: | Text |
Language: | English |
Published: |
Oxford University Press
1990
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Subjects: | |
Online Access: | http://intqhc.oxfordjournals.org/cgi/content/short/2/2/161 https://doi.org/10.1093/intqhc/2.2.161 |
Summary: | General Practitioners feel increasing pressure from Public Health authorities to evaluate their work but generally accept outcome indices such as morbidity and mortality are too far away from GP practices to allow direct evaluative conclusions. A simple instrument is needed to assess the evolution in the health status of the populations the GP serves. To design such an instrument we developed a short, inexpensive questionnaire, to be filled in by the GP, that covers as many fields of health care as possible and reflects as closely as possible the specific approach in family practice. To construct this instrument five Guttman scales were first developed that refer to the five frameworks of thought that a general practitioner uses, and submitted them to a process of validation. A composite index (SAMI) was mathematically derived from these five scales; it proved to be a valid instrument for measuring health status. To field test the SAMI index, a prospective cohort study was carried out in two subpopulations, Belgians and migrants, consulting seven GP practices. The evolution of four reasons for encounter (low back pain, pregnancy, diabetes and epigastralgia) were monitored by means of the five scales and the SAMI index. The evaluative conclusion that, despite special efforts of the GPs, their approach to migrants has to be reconsidered, is drawn. Above all the field test has shown that the five measurement scales and the global SAMI index are valid instruments, of easy use in general practice, that allow to assess the global health status of patient populations and give opportunities for evaluation of PHC services. |
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