Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

BMJ Open. 2015 Apr 21;5(4):e007443. doi: 10.1136/bmjopen-2014-007443.


Objectives: To examine the effectiveness of the quality management programme--European Practice Assessment--in primary care in Switzerland.

Design: Longitudinal study with three points of measurement.

Setting: Primary care practices in Switzerland.

Participants: In total, 45 of 91 primary care practices completed European Practice Assessment three times.

Outcomes: The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: 'infrastructure', 'information', 'finance', and 'quality and safety' to examine changes over time.

Results: Significant improvements were found in three of four domains: 'quality and safety' (F=22.81, p<0.01), 'information' (F=27.901, p<0.01) and 'finance' (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01).

Conclusions: The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care.

MeSH terms

  • Analysis of Variance
  • Humans
  • Longitudinal Studies
  • Primary Health Care / organization & administration*
  • Primary Health Care / standards
  • Quality Assurance, Health Care / methods*
  • Quality Improvement / standards*
  • Quality Indicators, Health Care / statistics & numerical data
  • Quality of Health Care / standards*
  • Switzerland