| title: | Clinical guidelines and the quality of health care as the factors affecting the course of disease, the quality of life and satisfaction with health care: the study of patients with type 2 diabetes, hypertension and bronchial asthma, and their family doctors |
|---|---|
| reg no: | ETF5239 |
| project type: | Estonian Science Foundation research grant |
| subject: |
3. Medical Sciences |
| status: | completed |
| institution: | University of Tartu |
| head of project: | Margus Lember |
| duration: | 01.01.2002 - 31.12.2004 |
| description: | Good quality health care has been defined as a service that meets the specific professional requirements, up-to date knowledge and available resources, guarantees patients with maximum welfare and health and causes minimum risks. The objectives of quality may be partly contradictory for the health care institution and patient. The doctor has to achieve quality without excessive costs, the patient must feel secure that the doctor¿s care is of professionally adequate quality. In order to guarantee patients with effective and optimal health care that meets modern requirements and is evidence-based, the elaboration and use of clinical and diagnostic guidelines has become widely used practice in doctors' everyday work. Clinical and diagnostic guidelines have been declared particularly necessary in the analysis of more common diseases in order to harmonise medical care and optimise costs spent on patients . The application of such guidelines has aimed to achieve a decrease in the number of hospitalisations, the amount of treatment costs and the smaller number of analyses performed, but also to improve patients quality of life and their satisfaction with health care. Although the need for clinical guidelines is usually not doubted, several studies have found that the implementation of such guidelines meets various obstacles. Whether the causes for not following clinical guidelines are caused by the patients or doctors, whether the abovementioned aims is achieved in reality is seldom investigated. The aims of this study are: 1. 1) To analyse of how family physicians use existing clinical and diagnostic guidelines for internal diseases in their everyday work. 2) To study whether the use of clinical and diagnostic guidelines affects:? the number of patients visiting the doctor? their satisfaction with health care ? their quality of life? the frequency of emergency aid given and hospitalisations? the number of days on sick leave 3) To determine which are the main causes for not following clinical and diagnostic guidelines ? caused by the doctor ? caused by the patient In the framework of the present project the aim is to concentrate on the chroni diseases for which there are clinical guidelines in Estonia. The methods of the study are:a questioning of patients and doctors, review of ambulatory records and hospital records. |
| project group | ||||
|---|---|---|---|---|
| no | name | institution | position | |
| 1. | Ruth Kalda | Dept. of Polyclinic and Family Medicine | assistant | |
| 2. | Helgi Kolk | Dept. of Internal Medicine | assistant | |
| 3. | Margus Lember | Dept. of Internal Medicine, University of Tartu | professror | |
| 4. | Kaja Põlluste | Institute of Public Health | senior assistant | |