Table 2 Types and design of A&F activities in the studied regions: summary from interviews with key informants
Giver & recipient of feedback | Purpose of A&F | Type of data | Modality of feedback |
|---|---|---|---|
Region as payer and regulator. | |||
Giver: contract manager and often medical advisor (GP). Recipient: PCC manager and key staff. | Control of compliance to contractual obligations. In combination with some support to learning and innovation at both practice and regional levels through dialogue and information exchange. | Combination of measures at practice level. Structural requirements regarding facilities, staff, compliance towards opening hours, collaboration agreements, patient satisfaction, adherence to clinical guidelines, waiting times etc. Targets linked to contractual obligations. Some targets related to quality measures. | Modality varies. Multimodal with face-to-face meetings in several regions (sometimes using Skype), usually annual or bi-annual. Data rarely available in-between feedback meetings. |
Regional pharmaceutical committees & the national The Swedish strategic programme against antibiotic resistance (STRAMA*). | |||
Giver: usually GP or senior professional. Recipient: PCC manager and individual prescribers (GPs). | Control of compliance to regional recommendations and evidence-based national targets. In combination with some support to learning and innovation through educational seminars, dialogue and exchange of information. | Process measures related to prescriptions and use of medicines at practice level and individual prescriber level. Targets linked to clinical guidelines, recommended drugs and restrictive use of antibiotics. | Usually multimodal. Face- to-face meetings (sometimes using Skype), usually more frequent than on an annual basis. Data available in-between feedback meetings. |
Owners of PCCs (public or private) | |||
Giver: controller and/or medical advisor (GP) Recipient: PCC manager. | Control of compliance to contractual obligations in combination with focus on efficiency measures. | Combination of measures at practice level and to some extent at individual staff level. Focus on costs and volumes of care in addition to measures used by the region. Targets focusing on costs and output volumes, waiting times and quality measures. | Frequency varies, often monthly. Face- to face meetings. Data sometimes available in-between feedback meetings. |