Capturing the complexity of European primary care systems in a European monitoring instrument.

Kringos, D., Boerma, W. Capturing the complexity of European primary care systems in a European monitoring instrument. Swiss Medical Weekly: 2009, 139(Suppl. 175), p. S 59. 15th Wonca Europe Conference,16-19 september 2009, Basel.
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Aim: The investment in PC reforms to improve the overall performance of health care systems has been substantial in Europe. There is however a lack of up to date comparable information to evaluate the development of primary care (PC) systems. This EU-funded PHAMEU (Primary Health Care Activity Monitor for Europe) study, aims to fill this gap by developing a PC Monitor for implementation in 31 European countries. Design and Methods: On the basis of a systematic literature review on PC, and consultations with experts across Europe, a comprehensive set of PC indicators has been developed. The indicator-set allows to assess stages of development of PC systems and identify possible elements to be improved. The focus is on patient’s access to PC services; continuity of care; coordination and integration; the range of services provided in PC, and outcomes. In 2009, a consortium involving organizations from 10 member states started implementing the developed Monitoring system by collecting PC data in 31 European countries by reviewing (inter)national literature and statistical databases, and consulting panels of national experts. Results: The evidence underlying the key functions of PC will be explained. It will be shown how the complexity of European PC can be captured with the Primary Health Care Activity Monitor. Results will be presented for a number of countries which form a contrast in the approach and stage of development of PC. Conclusions: The study has developed a monitoring instrument for PC development applicable to all configurations of PC in Europe, producing comparable information. Results are meant to be used by national decision makers, medical professional organizations, patient organisations, and PC providers, to better inform the policy making process for strengthening health systems through PC. (aut. ref.)