TY - JOUR T1 - The strength of primary care in Europe: an international comparative study JF - British Journal of General Practice JO - Br J Gen Pract SP - e742 LP - e750 DO - 10.3399/bjgp13X674422 VL - 63 IS - 616 AU - Dionne Kringos AU - Wienke Boerma AU - Yann Bourgueil AU - Thomas Cartier AU - Toni Dedeu AU - Toralf Hasvold AU - Allen Hutchinson AU - Margus Lember AU - Marek Oleszczyk AU - Danica Rotar Pavlic AU - Igor Svab AU - Paolo Tedeschi AU - Stefan Wilm AU - Andrew Wilson AU - Adam Windak AU - Jouke Van der Zee AU - Peter Groenewegen Y1 - 2013/11/01 UR - http://bjgp.org/content/63/616/e742.abstract N2 - 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. ER -