Author/Editor		Bulc, Mateja; Kersnik, Janko; Boerma, WGW; Pellny, Martina
Title		Raziskava o zagotavljanju kakovosti v slovenskem osnovnem zdravstvu
Translated title		Primary health care quality management project
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 48, št. 1
Publication year		2009
Volume		str. 1-17
Language		slo
Abstract		Background: The article summarizes the main results of the WHO Primary Care Quality Management project, which has been implemented as a pilot study to identify and support mechanisms for quality management in primary health care.Methods: The project was commissioned by WHO Europe and carried out in 2007 by NIVEL in collaboration with the University of Ljubljana, Department ofFamily Medicine, Medical Faculty of Ljubljana, and National Health Instituteof Uzbekistan. In Slovenia it was implemented in the urban region of Ljubljana and in the semi-urban region of Gorenjska. Tree types of questionnaires were used: one for policy/decision makers (experts from the Ministry of Health, representatives of professional associations, National Health Insurance Institute, human rights ombudsman, association of patients and consumers), one for managers of primary health care facilities and one forall practicing family physicians in the two areas. All data were processed and analyzed by the NIVEL Institute. Results: Of the 244 questionnaires sent out,106(43.4%) were completed and returned. At the policy/decision-making level, 11 (65%) participants out of 17 returned the questionnaires. At the management level, nine (64%) of the14 questionnaires completed in Ljubljana and five (39%) of the 13 questionnaires filled in Gorenjska were returned. In Ljubljana, 63 (49%) out of the130 practicing family physicians completed the questionnaire, and in Gorenjska only 18 (26%) out of 70. Conclusions: The study showed that quality assurance is not yet a matter of priority in the Slovene health care system. Stake holders do not pay adequate attention to this issue, and managers lack information and guidelines on the subject. Practicing family physicians would need protected time for systematic quality control and improvement, and above all, assistance by a secondary level professional body for family medicine.
Summary		Namen: Članek predstavi rezultate pilotskega projekta Svetovne zdravstvene organizacije v Sloveniji, katerega cilj je bila izdelava in preizkus orodja zaocenjevanje zagotavljanja kakovosti v osnovnem zdravstvu oziroma v družinskimedicini. Metoda: Raziskava, ki jo je vodila Svetovna zdravstvena organizacija ob pomoči Inštituta Nivel in Katedre za družinsko medicino Medicinske fakultete Univerze v Ljubljani, je hkrati potekala v Ljubljani (mestno področje) in na Gorenjskem (mestno in podeželsko območje). Orodje raziskave so bili trije vprašalniki za tri ravni: raven odločanja (Ministrstvoza zdravje, Slovensko zdravniško društvo, Združenje zdravnikov družinske medicine, Zdravniška zbornica Slovenije, Medicinska fakulteta, Zavodza zdravstveno zavarovanje Slovenije, organizacije bolnikov), raven vodenja v zdravstvu (direktorji, vodje enot in vodje služb zdravstvenega varstva odraslih omenjenih področij) in raven izvajanja (vsi aktivni zdravnikidružinske medicine na obeh področjih). Odgovore na vprašalnike je analiziral Inštitut Nivel. Rezultati: Poslali smo 244 vprašalnikov, odgovorov pa smo dobili 106 (43,4 %). Na ravni odločanja je odgovorilo 11 udeležencev od17 naprošenih (65 %). Na ravni vodenja smo prejeli 9 odgovorov od 14 poslanih (64 %) vprašalnikov v Ljubljani in 5 (39 %) od 13 poslanih na Gorenjskem. V Ljubljani je odgovorilo 63 (49 %) od 130 aktivnih zdravnikov družinske medicine, na Gorenjskem pa 18 (26 %) od 70 aktivnih zdravnikov družinske medicine. Zaključek: Raziskava je pokazala, da kakovost še ni prioriteta slovenskega osnovnega zdravstva. Tvorci zdravstvene politike ji ne posvečajo dovolj pozornosti, vodstvene strukture zdravstvenih zavodov nimajo dovolj informacij in pogrešajo navodila, zdravniki družinske medicine pa pogrešajo rezervirani čas za sistematično izboljševanje kakovosti svojega dela, še posebej pa krovno institucijo družinske medicine na sekundarnem nivoju.