Increasing patient centredness in outpatient care through closer collaboration with patient groups?. An exploratory study on the views of health care professionals working in quality management for office-based physicians in Germany

摘要

Objectives: In Germany, "self-help friendliness" is an upcoming popular concept for the promotion of patient centredness through closer cooperation of health care services with self-help groups of chronically ill and/or disabled patients and their relatives. The study aimed at gathering information from physicians with special expertise in quality management on opportunities for and barriers against introducing more collaboration between physicians and self-help groups in outpatient care. Methods: A cross-sectional explorative survey was conducted with quality circle moderators (group leaders) from four German federal states in 2008 and 2010 (n= 624 or 32.1% respondents out of 1943). Main outcome measure was the moderators' assessment of their peers, measured with 18 items. Statistical analyses were mainly descriptive, supplemented by subgroup analyses by federal state and characteristics of the respondents. Results: Moderators see a large willingness of outpatient physicians to integrate self-help activities, and many opportunities for better cooperation with patient groups. Nevertheless, most types of cooperation need activation and motivation. To enhance the cooperation, additional fees by health insurance funds, CME credit points and the decrease of doctors' work load are most likely to be effective. Conclusions: Given the willingness of office-based physicians to cooperate with patient groups, increased patient centredness through cooperation seems to be an achievable quality target in medical practices in Germany. Self-help-friendliness in medical practices is considered as an important partnership approach; however, the implementation is still in the early stages and has to overcome diverse barriers, mainly based on unfavourable opinions, negative attitudes and lack of incentives.