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Overview and future challenges for primary care.

Boerma, W., Bourgueil, Y., Cartier, T., Hasvold, T., Kringos, D., Kroneman, M. Overview and future challenges for primary care. In: Kringos, D.S., Boerma, W.G.W., Hutchinson, A., Saltman, R.B. Building primary care in a changing Europe. Kopenhagen: World Health Organization, 2015. 119-134
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This final chapter places the results of the previous chapters in a broader perspective by sketching the state of primary care in Europe in relation to current and future challenges, and drawing relevant lessons on the basis of the comparative information in this volume. The PHAMEU study has added evidence to what was known before from international studies. These studies have provided evidence on benefits of well-developed primary care systems, in terms of better coordination and continuity of care and better opportunities to control costs (Starfield, 1994; Delnoij et al., 2000; Shi et al., 2002; Macinko, Starfield & Shi, 2003). The added value of the PHAMEU approach has been that it has covered a larger number of European countries, which makes the results more robust and relevant for Europe. This chapter is structured as follows. First, the situation of primary care in Europe will be assessed through an overview of the main findings and the results of the in-depth analyses of the PHAMEU data. The subsequent section contains reflections on the findings, including: how the evidence can be applied; an agenda for primary care innovation; developments in the divide between eastern and western Europe; and reflection on essential primary care features like accessibility, equity, integration and skill-mix. Then there is a section devoted to future primary care monitoring, in particular what lessons can be learned from the PHAMEU project. Finally conclusions will be drawn. (aut. ref.)