[Information for planning and comparison in municipalities. Use of data from the EDP medical records in general practice]. / Informasjon til planlegging og sammenlikning i kommunene. Bruk av data fra EDB-journalen i allmennpraksis.

There is a lack of systematic data on primary care which can be used for purposes of planning and evaluation. Ordinary data from computer-based journals in general practice were collected in four municipalities. 25 general practitioners participated for four months in 1992. The validity and reliability of the data have been investigated. The computer-based journal provides accurate information on the number and kind of contacts, and on who uses the primary health services. It also tells the nature of each contact, whether it leads to a referral, a prescription or a laboratory test. It does not give exact data on illness rates in the population, but there is a relatively stable relationship between illness and the number of contacts in general practice. This makes it possible to compare the diagnoses made in different areas. The data from the computer-based journal is also a convenient way of comparing effectiveness and costs in general practice.

[Information for quality assurance and self-evaluation in general practice. Use of data from the EDP medical records in general practice]. / Informasjon til kvalitetssikring og selvevaluering i allmennpraksis. Bruk av data fra EDB-journalen i allmennpraksis.

A project was carried out to study the usefulness of ordinary data from computer-based journals for comparing practices. 20 general practitioners from four municipalities participated for four months in 1992. The computer-based journal provides accurate information on the number and kind of contacts with patients, and on who visits the general practitioner. It also tells what is done at each contact, such as a referral, prescription or laboratory tests. Using the International Classification of Primary Care (ICPC) even the most common diagnoses do not account for more than 3% of the consultations. The practice of the different doctors varies considerably as regards classifying consultations on a symptom level (ICPC 1-29) or a diagnosis level (ICPC 70-99). The results brought to light marked differences with regard to what general practitioners do, and what kind of problems their patients present. The patient populations differed to a lesser degree with respect to sex, age and social status. The findings provided an interesting and useful platform for group discussions among the participating doctors.

[Quality assurance of municipal health services]. / Kvalitetssikring i kommunehelsetjenesten.

The article describes what can be done to improve quality in the Norwegian primary health services, seen from the point of view of the municipal health officer. Quality assurance is particularly important in the primary health services for the following reasons: They, i.e. the primary health services constitute a major part of the total health services, and they are unique by being a basic front-line service consisting of many small units. Compared with the rest of the health services, many of the personnel employed at these units are not fully qualified. As a consequence, we argue that setting quality standards and ensuring and improving quality in patient care must be an integrated part of the work of all primary health care personnel. Ensuring quality has been a major issue for the national health authorities in recent years, but has not yet been incorporated as a routine in the services. We give six examples where quality assurance is relevant, with references from research.