DECENTRALIZED DIAGNOSTICS OF BETA-HEMOLYTIC STREPTOCOCCI GROUP-A - INTRODUCTION OF A DEVELOPMENTAL MODEL FOR MICROBIOLOGICAL CONSULTATION IN PRIMARY HEALTH-CARE

Objective - To define and evaluate forms for introduction of decentral ized diagnosis in primary care. Design - The study was divided into th ree phases. Intervention I. An intensive course on microbiological dia gnostics in cases of tonsillitis with information about rapid EIA-base d test kits for beta haemolytic streptococci group A. Intervention II. External quality assurance of the decentralized test. Evaluation. Rec ording of changes in work practice and attitude regarding decentralize d diagnosis by means of a questionnaire. Participants - Thirty-three G Ps and 36 laboratory technicians from 37 primary health care centres ( PHC) in the county of Ostergotland, Sweden. Results - Thirty-one of th e responding GPs (94%) considered that the information gained from qua lity assurance was useful. Twenty-nine GPs (88%) reported that they ha d changed their clinical practice to some extent, and 26 of the respon ding laboratory technicians (72%) reported that they had changed metho d after the interventions. Conclusion - Uniform acceptance was not ach ieved, but a large number of GPs and PHC laboratory technicians did co nform to a rational-empirical strategy for change in clinical practice .