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OBJECTIVES To measure quality of care at general practice consultations in diverse geographical areas, and to determine the principal correlates associated with enablement as an outcome measure. DESIGN Cross sectional multipractice questionnaire based study. SETTING Random sample of practices in four participating regions: Lothian, Coventry,(More)
In 1999 Shah 1 and others said that the Royal College of General Practitioners should advocate longer consultations in general practice as a matter of policy. The college set up a working group chaired by A P Hungin, and a systematic review of literature on consultation length in general practice was commissioned. The working group agreed that the available(More)
BACKGROUND Service users and providers have stated that delivering continuity of care to people with severe mental illness should be a service priority. We reviewed literature on continuity of care for people with severe mental illness (SMI) in order to identify factors that promote and impede this process. METHOD A systematic search of electronic(More)
BACKGROUND A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases)(More)
BACKGROUND There is a lack of tools to evaluate and compare Electronic patient record (EPR) systems to inform a rational choice or development agenda. OBJECTIVE To develop a tool kit to measure the impact of different EPR system features on the consultation. METHODS We first developed a specification to overcome the limitations of existing methods. We(More)
OBJECTIVES Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists.(More)
INTRODUCTION Patients increasingly receive care from multiple providers in a variety of settings. They expect management continuity that crosses boundaries and bridges gaps in the healthcare system. To our knowledge, little research has been done to assess coordination across organizational and professional boundaries from the patients' perspective. Our(More)
BACKGROUND In the UK routinely collected computerized clinical data is used to assess progress towards financially incentivised quality targets for chronic disease management including hypertension. OBJECTIVE To develop a method for assessing the impact of recording quality target data in the clinical consultation. METHODS Raters were trained how to(More)
This perspective paper makes a brief conceptual review of continuity and argues that relationship continuity is the most controversial type. Plentiful evidence of association with better satisfaction and outcomes urgently needs to be supplemented by studies of causation. The scope of these has been outlined in this paper. Evidence strongly suggests that(More)