RT Journal Article
SR Electronic
T1 The strength of primary care in Europe: an international comparative study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e742
OP e750
DO 10.3399/bjgp13X674422
VO 63
IS 616
A1 Dionne Kringos
A1 Wienke Boerma
A1 Yann Bourgueil
A1 Thomas Cartier
A1 Toni Dedeu
A1 Toralf Hasvold
A1 Allen Hutchinson
A1 Margus Lember
A1 Marek Oleszczyk
A1 Danica Rotar Pavlic
A1 Igor Svab
A1 Paolo Tedeschi
A1 Stefan Wilm
A1 Andrew Wilson
A1 Adam Windak
A1 Jouke Van der Zee
A1 Peter Groenewegen
YR 2013
UL http://bjgp.org/content/63/616/e742.abstract
AB Background A suitable definition of primary care to capture the variety of prevailing international organisation and service-delivery models is lacking.Aim Evaluation of strength of primary care in Europe.Design and setting International comparative cross-sectional study performed in 2009–2010, involving 27 EU member states, plus Iceland, Norway, Switzerland, and Turkey.Method Outcome measures covered three dimensions of primary care structure: primary care governance, economic conditions of primary care, and primary care workforce development; and four dimensions of primary care service-delivery process: accessibility, comprehensiveness, continuity, and coordination of primary care. The primary care dimensions were operationalised by a total of 77 indicators for which data were collected in 31 countries. Data sources included national and international literature, governmental publications, statistical databases, and experts’ consultations.Results Countries with relatively strong primary care are Belgium, Denmark, Estonia, Finland, Lithuania, the Netherlands, Portugal, Slovenia, Spain, and the UK. Countries either have many primary care policies and regulations in place, combined with good financial coverage and resources, and adequate primary care workforce conditions, or have consistently only few of these primary care structures in place. There is no correlation between the access, continuity, coordination, and comprehensiveness of primary care of countries.Conclusion Variation is shown in the strength of primary care across Europe, indicating a discrepancy in the responsibility given to primary care in national and international policy initiatives and the needed investments in primary care to solve, for example, future shortages of workforce. Countries are consistent in their primary care focus on all important structure dimensions. Countries need to improve their primary care information infrastructure to facilitate primary care performance management.