Measuring the strength of primary care systems in Europe.

Kringos, D.S., Boerma, W.G.W. Measuring the strength of primary care systems in Europe. European Journal of Public Health: 2009, 19(suppl. 1), p. 64. Abstract. 17th European Public Health Conference 'Human Ecology and Public Health', 25–28 November 2009, Lodz (Polen).
Background: The investment in primary care (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 and strength of PC systems. This EU-funded Primary Health Care Activity Monitor for Europe (PHAMEU) study, aims to fill this gap by developing a PC Monitor for implementation in 31 European countries. Methods: On the basis of a systematic literature review, 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. Focus is on the structure (governance, financing, workforce development), process (access, continuity, coordination, comprehensiveness) and outcome (quality, efficiency, equity) of PC systems. In 2009, the PHAMEU project collected data across Europe by reviewing (inter)national literature and statistical databases, and consulting panels of national experts. Results: The evidence underlying the key functions of strong PC will be explained. It will be shown how the complexity of European PC can be captured with the PC Monitor. Particular attention will be paid to the importance of hospitalization for PC sensitive conditions as indicator to measure the quality of PC systems. It will be shown how the development of PC can influence hospital use and admissions. Conclusions: The study has developed a monitoring instrument for PC development applicable to all configurations of PC in Europe. Avoidable hospitalization for PC sensitive conditions is an important indicator for the strength of a PC system’s structure and organization. Results are meant to be used to better inform the policy making process for strengthening health systems through PC.