General practitioners' compliance with guidelines for antenatal care

Abstract

Objective — To assess general practitioners' compliance with Norwegian guidelines for antenatal care issued in 1984 and to identify characteristics of physicians with low compliance.

Setting — Routine clinical practice in primary care.

Methods — The content of the care was assessed from nine procedures, the selection of which was based on a previous perinatal audit. A 'compliance score' was established and logistic regression analysis was used to estimate pregnant women's odds for a low score by characteristics of their care-providing GPs.

Results — GPs' compliance with the guidelines was lower for procedures which required recording of a clinical judgment. The odds for a low score increased significantly if the doctor was a male or worked in a single rather than a group practice. There was no association between compliance score and fetal outcome, or between compliance score and the effectiveness of antenatal care measured as the detection of major obstetric disorders.

Conclusion — The gender specific differences in GPs' antenatal care performance were the same as those reported by others. These findings warrant further research.

Study population — All women permanently residing in the county of Oppland who gave birth during a 12-month period 1988-89 and the general practitioners who provided their antenatal care.

Key Words:

• antenatal care
• compliance
• clinical guidelines