Up-to-date indicators to compare primary care in countries

NIVEL has, together with international partners, developed an up-to-date set of indicators to unambiguously compare primary care systems between countries. How primary care systems are organised in countries can influence the results of the care provided. That is why it is important to take these characteristics into account in the comparison of healthcare outcomes between countries.

The design of primary care differs greatly between countries. Differences are related to legislation, available healthcare providers and how they are paid, the method of health insurance and the rules for access to primary and secondary care. Healthcare providers also differ in how they work together, both within primary care and between primary care and other sectors, such as hospitals, mental healthcare institutions and nursing homes.

Strong primary care increases the accessibility of care 

Strong primary care provides patients with good access to care and ensures referral and coordination if more specialistic care is needed. That role contributes to a good functioning of health care as a whole, something that is increasingly recognized.

New indicators tailored to recent developments in healthcare 

With a recently updated system of indicators for measuring primary care - called SiSPC (Systemic Indicators for the Strength of Primary Care) - researchers can map the strength of primary care. From time to time, those indicators must be measured and updated to remain tailored to recent developments in healthcare.
 

More than 15 years ago we developed and measured a system of indicators - Phameu or Primary Care Activity Monitor Europe - but that is now outdated. With SISPC we are going to collect new data about the strength of the first line. This will again be done. A lot of international comparative research can be done

Wienke Boerma, PhD

Steps in the development of the SiSPC system of indicators

• In step 1 (see figure), usable elements have been selected from an indicator set of almost 20 years ago (PHAMEU - Primary Health Care Activity Monitor Europe).
• Steps 2 and 3 concern literature research into recent frameworks that map primary care systems. Suitable indicators were selected from this.
• In step 4 we have made an inventory of publications about current challenges in primary care and how to deal with them. This step resulted in 15 topics on which provisional indicators were formulated, insofar as not yet covered by indicators from the previous steps.
• Broad international feedback on a provisional list finally resulted in the SISPC set.

About the research 

The development process of the SISPC indicators, the NIVEL carried out in collaboration with researchers from the Austrian National Public Health Institute (Gesundheit Österreich, Vienna), the Avedis Donabedian Research Institute (Fundació Avedis Donabedian, Barcelona Perrance Performance Performance Performance Performance Performance Center) (Singapore). Want to know more? View the integral report, including the set indicators.