Table 1. Initial Categories Identified by the Focus Groups

From: Development and Pilot Testing of Quality Indicators for Primary Care in Japan

Category Content
1 Comprehensive care First contact care for common diseases and ailments, including minor surgery. Consultation for subclinical conditions or wide-range health issues. Prevention, including vaccination or screening, is also important.
2 Accessible care Providers should be in the local vicinity. Out-of-hours care, especially telephone access and referral, should be guaranteed.
3 Communication Good and humane communication with patients. Friendliness, humanity, respect for patients, informed consent, privacy, and patient preferences should be promoted.
4 Coordination Coordination and collaboration with multiple other professionals. Other resources such as other specialty clinics/hospitals, pharmacies, care coordinators. Among these inter-professional collaborations, primary care clinics should act as a local team leader.
5 Standardized care Adherence to evidence-based practice, using concordance to standardized care guidelines such as clinical guidelines, and rules of the national insurance regime, and local law/ordinance. Continuous updating of current knowledge and skills. Standardized care, including safety issues, such as infection control, should be provided in accordance with public expectations.
6 Understanding of patient background Taking various aspects of life into consideration, primary care clinics should provide care which focuses more on the outcomes than medical outcomes, especially for the elderly. Attention should be given to daily behavior, including foods, cost, and enhanced shared-decision making. Patient-centered care.
7 Contribution to the community Public activities such as out-of-hours clinic or emergency care in the community. Social support includes public education for people at local clinics, and social support for their community.
Table 2. Final Categories and QIs.

From: Development and Pilot Testing of Quality Indicators for Primary Care in Japan

Category Number of Items Contents (examples) Data resources
Comprehensive care/Standardized practice 20 Smoking history, advice on smoking cession, pneumococcal vaccination, dementia care, hypertension, diabetes, asthma, emergency (acute abdomen, headache), drug treatment of chronic care condition, vaccination for children, monitoring history of other treatment, checking the prescription history MCD 3
MCR 15
PS 2
Access 3 Out-of-hours care
Response to symptoms other than current monitoring care
PS 3
Communication 8 Respect for patient preferences, plain explanation of drugs. Respect for patient privacy. Friendliness, sincere and honest attitude PS 8
Coordination 5 Referral letter, identifying care coordinator, helping identifying specialists MCR 2
PS 3
Understanding of patient background 6 Asking about family members in the house, costs, understanding their role, consideration of the local community MCR 1
PS 5
Table 3. Comparison of Categories Across Other Indicators in Primary Care.

From: Development and Pilot Testing of Quality Indicators for Primary Care in Japan

Quality Indicators for Primary Care Practice in Japan (QIPC-J) Quality in Family Practice Book of Tool (QBT) in Canada Institute of Medicine
1 Comprehensive care
2 Accessible care Timely and accessible Timeliness
3 Communication Patient-Centered Patient-Centered
4 Coordination Integrated and Continuous
5 Standardized care Effective clinical practice Effective
Safe Safe
Efficient Efficient
6 Understanding of patient background Patient-Centered Patient-Centered
7 Contribution to the community Equitable Equitable
Appropriate practice resources
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