Labour intensity of guidelines may have a greater effect on adherence than GPs' workload.

BMC Family Practice
Michael J van den BergPeter P Groenewegen

Abstract

Physicians' heavy workload is often thought to jeopardise the quality of care and to be a barrier to improving quality. The relationship between these has, however, rarely been investigated. In this study quality of care is defined as care 'in accordance with professional guidelines'. In this study we investigated whether GPs with a higher workload adhere less to guidelines than those with a lower workload and whether guideline recommendations that require a greater time investment are less adhered to than those that can save time. Data were used from the Second Dutch National survey of General Practice (DNSGP-2). This nationwide study was carried out between April 2000 and January 2002.A multilevel logistic-regression analysis was conducted of 170,677 decisions made by GPs, referring to 41 Guideline Adherence Indicators (GAIs), which were derived from 32 different guidelines. Data were used from 130 GPs, working in 83 practices with 98,577 patients. GP-characteristics as well as guideline characteristics were used as independent variables. Measures include workload (number of contacts), hours spent on continuing medical education, satisfaction with available time, practice characteristics and patient characteristics. Outcome m...Continue Reading

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Citations

Jul 27, 2011·Family Practice·Liset van DijkDinny H de Bakker
Sep 13, 2013·BioMed Research International·Søren BirkelandJakob Kragstrup
Jan 22, 2013·Scandinavian Journal of Primary Health Care·Christel E van DijkDinny H de Bakker

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