International Journal of Epidemiology, Vol 26, 166-172, Copyright © 1997 by International Epidemiological Association
P Chauvin and AJ Valleron
OBJECTIVES: This study was undertaken to develop a novel approach to
measure compliance of general practitioners (GPs) in sentinel public health
surveillance. More specifically, its purpose was to determine the
characteristics in the SGP's profile which can be objectively associated
with perseverance. METHODS: Since 1984, the French sentinel network has
collected weekly data on eight communicable diseases, involving volunteer
SGPs. In this study, 'compliance' was defined as the length of time during
which a SGP complies with a given theoretical surveillance protocol. This
left-censored variable was computed from individual SGP's connection time
series. Kaplan-Meier method was used to estimate the compliances survival
distribution for all the SGPs (1824 SGPs who have been part of the network,
at one point, or another, since 1984). Using Cox regression model, a
prospective survey on the 376 most recent recruits allowed us to select the
characteristics associated with a longer compliance. Sensitivity analyses
were carried out using the bootstrap method. RESULTS: According to the
maximum number of silences allowed by the given theoretical protocol,
median compliances varied between 11.7 (95% CI: 11.1-12.3) and 38.8 (95%
CI: 35.7-40.7) months. In multivariate analyses we observed long
compliances for SGPs whose main motivation for being involved in the
network was an interest in epidemiology and SGPs with < or = 5 or >
or = 20 years seniority. On the other hand, interest in local
epidemiological surveys and previous experience with other surveillance
networks were associated with short compliances. We found no statistical
association between compliance and computing experience, having a medical
secretary, a particular feeling of being a 'public health actor', or the
desire to belong to a GPs' network. CONCLUSION: We have shown our
longitudinal method to be an efficient tool for monitoring non-compliant
SGPs with respect to given surveillance protocols. Furthermore, this
approach allows us to select out of the SGPs' profile the characteristics
which are associated with a longer compliance. This regression model could
be further refined by extending the SGPs' profile. The additional variables
to be taken into account in this profile could be identified through a
complementary sociological approach. Our work addresses the question of
understanding what determines the motivation of GPs to participate in
public health surveillance. This question is essential if we hope to turn
general practice information systems into genuine public health
surveillance tools.
ARTICLES
Monitoring the compliance of sentinel general practitioners in public health surveillance: which GPs persevere?
Unite de Recherche 'Epidemiologie et Sciences de l'Information' de l'INSERM, Institut federatif Saint-Antoine de Recherches sur la Sante, Paris, France.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. G. Deckers, W J. Paget, F. G Schellevis, and D. M Fleming European primary care surveillance networks: their structure and operation Fam. Pract., April 1, 2006; 23(2): 151 - 158. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Bravata, K. M. McDonald, W. M. Smith, C. Rydzak, H. Szeto, D. L. Buckeridge, C. Haberland, and D. K. Owens Systematic Review: Surveillance Systems for Early Detection of Bioterrorism-Related Diseases Ann Intern Med, June 1, 2004; 140(11): 910 - 922. [Abstract] [Full Text] [PDF]
|
|