European primary care under the magnifying glass

An international consortium, lead by NIVEL, developed a measurement instrument to produce comparable information on the variation of primary care systems across Europe. The instrument has been published in BMC Family Practice.

To evaluate the current state of primary care in a country one needs a benchmark, for example by comparing the system with other countries. NIVEL (Netherlands Institute for Health Services Research) developed a measurement instrument to produce comparable information on the variation of primary care systems across Europe. The instrument has been used in 2009/10 for a first measurement in 31 countries. Several doctors, policy makers and researchers from all EU member states and Switzerland, Norway, Iceland and Turkey provided key data. The results will be published mid-2011.
With the knowledge produced by the monitor it is possible to inform policy makers on possible strategies to improve the performance of primary care in their country. “The Primary Care Monitoring Instrument enables us for example to relate the outcomes of primary care to policy initiatives implemented in a country”, states NIVEL-researcher Dionne Kringos. “The Primary Care Monitor can, therefore, serve as an instrument for policy evaluation.”

Strengths and weaknesses
By implementing the Primary Care Monitor at regular time intervals, one could observe the progress or development of primary care, says Kringos. “One could identify the weaknesses of primary care in a country. Solutions for similar problems in other countries can be used to improve one’s own primary care system.”
The information produced by the Primary Care Monitor can also be used for further research, for example focussed on the contribution of primary care on outcomes such as inequality in health, health care utilisation or costs. NIVEL started with this line of research early 2010 in the QUALICOPC project (Quality and Costs of Primary Care). This project studies the effects of primary care on quality of care, costs, and equity in countries within and outside Europe, like New Zealand and Australia.

In order to develop the measurement instrument, researchers have been scanning through over 6000 recent publications about primary care, looking for the basic functions, independent of the national context. One of these basic functions is that primary care should be accessible – also financially speaking – and should offer a broad range of healthcare services for basic health needs. The researchers developed indicators, to make it possible to measure these functions, and a group of international experts assessed these indicators and adapted them to the European situation. With these indicators as a starting point, NIVEL developed an online database where doctors, policy makers and researchers from 31 European countries could enter data about their country.
Widespread use of the instrument has the potential to improve the understanding of primary care delivery in different national contexts and thus to create opportunities for better decision making.
Subsidized by
- European commission DG Sanco

Cooperating partners
- Cooperating partners Phameu