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 |