Publication date

Primary care quality management in Slovenia.

Boerma, W.G.W., Kringos, D.S., Verschuuren, M., Pellny, M., Bulc, M. Primary care quality management in Slovenia. Kopenhagen: WHO Regional Office for Europe, 2008. 83 p.
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Of all GPs in Slovenia 86% are not interested in activities to systematically improve care. A clear national quality policy, further education for care managers and financial incentives for GPs could change the picture, as NIVEL research – done on the initiative of the World Health Organisation (WHO) – has shown. The results have been published in a WHO report.

No core activity
Quality improvement is not a core activity of the average Slovene GP. For instance, he or she hardly ever does any practice-based research and hardly ever consults a specialist. Structural quality audits are also conducted only to a very limited extent. A vast majority of GPs regularly uses clinical guidelines; however, these guidelines are often outdated and created without national coordination. When asked for the effects of quality improvement interventions, more than half of the GPs answered to expect these to result in higher expenditure and extra workload.

In Slovenia, most GPs are salary employed. Their managers say that they do not receive sufficient management information about the quality delivered in their health care centres. An example: there are no regular job performance interviews with GPs. GPs are hardly ever stimulated to reflect on their daily business and the delivered quality of care and service in practice. The GPs unanimously agreed that a stimulating leadership would be more effective to improve care than imposing sanctions.

In an agreement with the WHO the Slovene Ministry of Health declared primary care quality management and improvement to be a national priority. In 2007, the WHO asked her Collaborating Centre NIVEL to develop a quality management instrument. This instrument, the Primary Care Evaluation Tool (PCET), has been tested in two regions in Slovenia. The report provides assistance and focused recommendations to improve managing care quality in Slovenia. The recommended strategies can also be relevant to policy makers and GPs in other countries.