Skip to main content

Table 1 56 Priority Indicators of the SPAM program (number in italic = indicator’s number)

From: Development of a monitoring instrument to assess the performance of the Swiss primary care system

Domain

Chapter

Section

A Structure

1. Accessibility

1.1. Access to the Health care System

1.1.1 Development of workforce supply

1

% by which the density of GP / FAMILY PHYSICIANS has increased or reduced over the most recent available 5 year period

1.1.2 Density available PC workforce

2

Density of GP / FAMILY PHYSICIANS per 100′000 population

1.1.3 GP-specialist ratio

3

Ratio of active GPs/active medical specialists

1.1.4 Age distribution GPs

4

Median age of practicing GPs on NATIONAL LEVEL

1.1.5 Social Accessibility

5

Average time for patients to travel from their home to their GPs independently of the mean of transport by RURAL AREAS

 

Priority sub indicators

 

1

Average time for patients to travel from their home to their GPs independently of the mean of transport by RURAL AREAS ≤20 min

 

2

Average time for patients to travel from their home to their GPs independently of the mean of transport by RURAL AREAS ≥21 to 40 min

 

3

Average time for patients to travel from their home to their GPs independently of the mean of transport by RURAL AREAS ≥41 to 60 min

 

4

Average time for patients to travel from their home to their GPs independently of the mean of transport by RURAL AREAS ≥61 min

A Structure

1. Accessibility

1.1. Funding of Health Care

1.2.1 Total PC expenditure

6

Ratio of total expenditure on PC / total expenditure on health

1.2.2 Expenditure on prevention and public health

7

Ratio of total expenditure on prevention and public health / total expenditure on health

1.2.3 Employment status of GPs

8

% of practicing GPs that are salaried by an INTEGRATED CARE ORGANIZATION

1.2.4 Financial status of GPs compared to a specialist

9

Ratio of annual median income of a GP to the annual median income of a SPECIALIST

1.2.5 Income of GPs

10

Annual median income of a GP on NATIONAL level

1.2.6 Cost-sharing for GP care

11

% of patients co-payment (next to coverage by insurance) for visit to GP as a ratio of total cost for visit to the GP

1.2.7 Medical insurances

12

% of patients with complementary insurance

A Structure

1. Accessibility

1.1. Organisation of Resources

1.3.1 Gate keeping System

13

General indicator: % of patients with “GP models” insurance contracts

14

General indicator: % of patients accessing other disciplines without referral of GP

A Structure

2 Health care

2.1 Medical education

2.1.1 Medical graduate trained in family medicine

15

Number of FMH titles in GIM obtained as ratio of the total number of FMH titles per year

2.1.2 New family medicine practices

16

Number of FMH-GIM doctors starting their activity in a private practice as a ratio of the total number of doctors with FMH-titles starting their activity in a private practice per year

B Output

3 Workflow of Resources

3.1. Workload of GPs

17

Average number of working hours per week of GPs

3.2 Medical record keeping

18

% of GPs keeping (or reporting to keep) electronic clinical records for all patient contacts routinely

3.3 Specialist-GP communication

19

% of specialists communication back to referring GP after an episode of treatment

3.4 Shared practice

20

% of PC practices that are single handed (solo) as a ratio of all practices

21

% of PC practices with mixed practice with GPs and medical specialists

3.5 Duration of GP consultation

22

Average consultation length (in minutes) of GPs

3.6 GP consultations

23

Number of GP consultations per capita per year

B Output

4. Content of Health Care

4.1 Clinical Care

4.1.1 Medical equipment available

24

% of practices having the following equipment in PC facilities: RADIOLOGY EQUIPMENT (X-Ray)

25

% of practices having the following equipment in PC facilities: LABORATORY

26

% of practices having the following equipment in PC facilities: DRUG DISPENSARY

27

% of practices having the following equipment in PC facilities: ECG

4.1.2 First contact care

28

% of GP providing first contact care for WOMAN AGED 35 WITH PSYCHOSOCIAL PROBLEMS

29

% of GP providing first contact care for patient with ALCOHOL ADDICTION PROBLEMS

4.1.3 Treatment and follow-up of diseases

30

% of GP’s providing treatment/follow-up care for patients with LOWER BACK PAIN

31

% of GP’s providing treatment/follow-up care for patients with MILD DEPRESSION

32

% of GP’s providing treatment/follow-up care for patients ADMITTED TO A NURSING HOME / CONVALESCENT HOME

4.1.4 Medical technical procedures

33

% of GP providing: WOUND SUTURING

4.1.5 GP contacts without referral

34

% of total patient contacts handled solely by GPs without referrals to other providers

4.1.6 Health promotion

35

% of GPs who offer individual counselling to the practice population. Counselling in case of OBESITY

36

% of GPs who offer individual counselling to the practice population. Counselling in case of SMOKING CESSATION

37

% of GPs who offer individual counselling to the practice population. Counselling in case of PROBLEMATIC ALCOHOL CONSUMPTION

4.1.7 Preventive care

38

% of GPs providing: SKIN SCREENING (FOR SKIN CANCER)

39

% of GPs providing: INFLUENZA VACCINATION FOR HIGH-RISK GROUPS

40

% of GPs providing: BLOOD SUGAR CONTROL

41

% of GPs providing: WEIGHT CONTROL

42

% of GPs providing: CHOLESTEROL LEVEL CONTROL

C Outcome

5 Status of patient’s health

5.1. General

5.1.1 Antibiotics consumption

43

Defined daily doses of antibiotics use in ambulatory care per 1000 inhabitants per day

C Outcome

5 Status of patient’s health

5.2 Chronic Care

5.2.1 Diabetes care

44

% of diabetic patients aged >25 years with overweight and obesity and BMI measured in the last 12 months

5.2.2 COPD care

45

% of patients with COPD that have had a follow-up visit in primary care during the last year

5.2.3 Control of hypertension

46

% of patients identified as hypertensive whose BP recorded in past year

5.2.4 Use of angiotensin converting enzyme inhibitors in those with heart failure

47

% of patients with heart failure who have a prescription for ACE inhibitors

C Outcome

5 Status of patient’s health

5.3 Prevention

5.3.1 Influenza vaccination in those aged over 65 years

48

% patients aged 65+ vaccinated against flu

5.3.2 Breast cancer screening

49

% of women aged 52–69 yrs. who had at least 1 mammogram in the past 3 yrs

5.3.3 Cervical cancer screening

50

% of women aged 21–64 yrs. who had at least 1 Pap test in the past 3 yrs

5.3.4 Aspirin for patients at high risk of coronary or ischemic cerebrovascular events

51

% of patients with diagnosis of IHD who take aspirin

5.3.5 Smoking cessation

52

% of patients whose smoking status recorded

53

% of patients who are current smokers and have received advice on stopping smoking or nicotine replacement therapy

C Outcome

6. Consumers satisfaction

6.1 Patients satisfaction

6.1.1 Patient satisfaction with the GP (PDRQ-9)

 

54

% of patients who are satisfied with their relation with their GP/PC physician

  

Priority sub indicators

 

5

% of patients assessing that their GP is helping them

 

6

% of patients assessing that their GP is dedicated to help them

 

7

% of patients assessing that their GP has enough time for them

 

8

% of patients have confidence in their GP

 

9

% of patients assessing that their GP understands them

 

10

% of patients assessing that they agree with their GP on the nature of my medical symptoms

 

11

% of patients assessing that they can talk to their GP

 

12

% of patients that feel content with their GP’s treatment

 

13

% of patients assessing that their GP is easily accessible

C Outcome

7. Equity

7.1 Access

7.1.1 Restriction of access to GP

55

 

% of patient who postponed or abstained from a visit to his doctor or another GP when it was needed in the past 12 months

 

7.1.2 Psychological needs asked by GP

56

 

% of GP practices having elaborated and/ or adopted procedures to meet the psycho-social needs of individual patients