Family Practice Vol. 20, No. 4, 443-451
© Oxford University Press 2003
International Health Care Research |
The development of quality circles/peer review groups as a method of quality improvement in Europe.
Results of a survey in 26 European countries
Institute for General Practice, University of Kiel, Kiel, Germany,
a Centre for Quality of Care Research, Department of General Practice and Social Medicine, University of Nijmegen, The Netherlands,
b Institute of Public Health, Jagiellonian University Krakow, Poland,
c Audit Project Odense, University of Southern Denmark, Odense, Denmark,
d Research Unit for General Practice, Aarhus University, Aarhus, Denmark,
e Irish College of General Practitioners, Dublin, Ireland,
f Scientific Society of Flemish GPs WVVH, Berchem, Belgium,
g Department for General Practice and Health Care Research, University of Heidelberg, Heidelberg, Germany.
Correspondence to Martin Beyer; E-mail: beyer{at}allgemeinmedizin.uni-kiel.de
Background. Peer review groups (PRGs) and quality circles (QCs) commenced in The Netherlands and have grown to become an important method of quality improvement in primary care in several other European countries.
Objective. Our aim was to provide an overview of QC/PRG activities and exemplary programmes in European countries.
Methods. A survey was performed in three consecutive steps by EQuiP (European Working Party on Quality in Family Practice), which is a representative association of experts from 26 European countries. The national representatives initially completed a structured questionnaire documenting the number and objectives of QCs/PRGs, sources of support and special programmes in their countries (step 1). In step 2, these sources were used to extend and validate the expert statements. Step 3 studied paradigmatic initiatives in depth.
Results. Step 1 took place in 2000; the response rate was 100% (26 countries). QCs/PRGs were very active in 10 countries; 16 countries showed little or no activity. Participation ranged from <2 to 86% of all GPs. Step 2 concentrated upon the countries with a high level of activity. Development appeared to be associated with establishment in private practice and the portion of GPs with vocational training. Eight programmes from six countries describing the establishment and the targeting of QC/PRG work are presented as case reports (step 3).
Conclusion. In the last 10 years, substantial development of QCs/PRGs has taken place in The Netherlands, the UK, Denmark, Belgium, Ireland, Sweden, Norway, Germany, Switzerland and Austria. Further evaluation is needed to clarify the impact on quality of care.
Keywords. Europe, health care, peer review, medical audit, quality assurance, quality circles.
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