Quality control in primary care: an instrument for constructing a database

An instrument for constructing a database and defining standards for quality control in primary care medicine is presented. A questionnaire adapted from a U.S. Department of Health and Human Services form will be used randomly at least twice a year for screening all patient-staff contacts in most Kupat Holim clinics in the Negev Region (small rural clinics excepted). Analysis of the responses will enable definition of standards for measuring the quality of primary care. The tool is simple, inexpensive, not too time-consuming, and can provide the required data. A pilot study to test the tool was carried out in 3 primary care clinics serving an insured population of 17,763. The study surveyed 474 patient visits to the clinics, of which 57% were consultations with a physician. The younger patients usually saw the physician, while the older tended to visit the nurse. The most common reason for clinic visits was an acute condition, and only 4% of visits were for administrative reasons. 28% of the patients were not prescribed any medication and 27% were prescribed only 1 drug. The majority of problems were dealt with at the clinic level and only a few were referred to specialists or to external diagnostic services.