Quality of care: the need for medical, contextual and policy evidence in primary care

Van Driel, Mieke L., De Sutter, An I., Christiaens, Thierry C. M. and De Maeseneer, Jan M. (2005) Quality of care: the need for medical, contextual and policy evidence in primary care. Journal of Evaluation in Clinical Practice, 11 5: 417-429. doi:10.1111/j.1365-2753.2005.00549.x


Author Van Driel, Mieke L.
De Sutter, An I.
Christiaens, Thierry C. M.
De Maeseneer, Jan M.
Title Quality of care: the need for medical, contextual and policy evidence in primary care
Journal name Journal of Evaluation in Clinical Practice   Check publisher's open access policy
ISSN 1356-1294
1365-2753
Publication date 2005-10
Sub-type Article (original research)
DOI 10.1111/j.1365-2753.2005.00549.x
Volume 11
Issue 5
Start page 417
End page 429
Total pages 13
Place of publication Oxford, United Kingdom
Publisher Blackwell Science
Language eng
Abstract The increasing availability of medical evidence in clinical practice was expected to improve the quality of care. However, this has not been realized. A possible explanation is that quality of care is a complex concept and needs a wider scope. Starting from the Donabedian triangle of structure, process and outcome, a framework for the analysis of quality of care is presented. The need for three types of evidence is identified and discussed: medical, contextual and policy evidence. Although the body of medical evidence is increasing, it has major flaws and gaps hampering its applicability in primary care. There is also a need to focus on the context of the medical encounter, which has been shown to influence outcome, but is still not well researched. Finally, evidence on costs, cost utility and equity needs to be considered. Taking these different aspects of evidence into account, an agenda for research in primary care is set. The analytical framework may provide new insights in the quest for improving quality of health care.
Keyword Context
Evidence-based medicine
Health policy
Primary care research
Quality of care
Theoretical framework
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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