High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands.

Background: The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands.

Methods: Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management.

General practitioners' workload associated to practice size rather than chronic care organisation.

Objective: This study aimed to explore the associations between chronic care organisation and physician workload in primary care.

Design: Secondary analysis of observational data.

Setting And Participants: One hundred and forty general practices from 10 European countries.

Follow-up of abnormal or inadequate cervical smears using two guidance systems: RCT on effectiveness.

Background: To improve follow-up compliance after an initial inadequate or abnormal cervical smear, two follow-up guidance systems were tested for effectiveness. A comprehensive system (cytopathology laboratory monitored the follow-up of all abnormal and inadequate smears) was compared to a selective system (monitoring was left to the smear taker; laboratory acted as a safety net).

Methods: In an RCT on all family practices (N = 171) in the catchment areas of two cytopathology laboratories (Nijmegen region, The Netherlands, 1998-2000), practices were allocated at random to one of the follow-up guidance systems.

Physician workload in primary care: what is the optimal size of practices? A cross-sectional study.

Objective: To determine the impact of practice size and scope of services on average physician workload in primary care practices in The Netherlands, and to examine the associations between average physician workload, average assistant volume and organisational practice characteristics.

Methods: This was a cross-sectional study in 1188 general practices in The Netherlands. Measures included physician workload per week per 1000 patients, assistant volume per 1000 patients, practice size defined by number of registered patients (10 classes), scope of disease management services (seven classes), and nine organisational characteristics of the practice.

Saying 'goodbye' to single-handed practices; what do patients and staff lose or gain?

Background: The practice setting is, next to the GP and staff, an important determinant of the quality of care. Differences between single-handed practices and group practices in practice management and organization could therefore provide clues for improvement. An explorative, cross sectional survey was conducted in 766 general practices in The Netherlands comparing single-handed practices with group practices.