HOW WELL ARE PATIENTS TREATED IN FAMILY-PRACTICE - QUALITY OF CONSULTATIONS FOR NONACUTE ABDOMINAL COMPLAINTS

Objective. To describe the application of weighted review criteria, de veloped by the Delphi technique, for the assessment of the quality of consultations concerning non-acute, abdominal complaints. Design. Desc riptive study in two parts: (i) comparison of actual family doctor (FD )-performance with predefined review criteria; (ii) calculation of qua lity scores per consultation, utilizing the weighted criteria. Setting . Sixty-two family practices across The Netherlands. Subjects. Eight-h undred and forty consultations concerning non-acute abdominal complain ts, first encounters. Main outcome measures. The percentage of consult ations in which each criterion was met; quality scores per consultatio n and their distribution. Results. (i) Little effort was made to trace risk groups for gastrointestinal malignancies (<50% of the consultati ons concerned); medication was often described without dietary advice (17%); inappropriate activities were not carried out on a large scale (6%). (ii) Quality scores were normally distributed. Conclusions. The Delphi technique yields a useful instrument for assessment of the qual ity of consultations. The review criteria for quality assessment of FD performance used in this study made it possible to distinguish quite clearly between high-and low-quality consultations. Some important def iciencies in daily practice emerged.