Publicatie datum

Primary care workforce development in Europe.

Groenewegen, P., Heinemann, S., Gress, S., Schäfer, W. Primary care workforce development in Europe. European Journal of Public Health: 2014, 24(suppl. 2) Abstract: 7th European Public Health Conference 'Mind the Gap: Reducing Inequalities in health and health care'. 19-22 November 2014, Glasgow.
Background: There is a large variation in the organization of primary care in Europe. In some health care systems, primary care is the gatekeeper to more specialized care, whilst in others patients have the choice between a wide range of providers. Primary care has increasingly become teamwork. Methods: To describe the composition of primary care teams in European countries and to describe urban-rural differences. We will present data from the EU co-funded QUALICOPCstudy that collected information about primary care in 34 countries mainly in Europe, but also including Australia, New Zealand and Canada. The study is based on a sample of GPs in
each country. The total number of GPs is approximately 6,500. Results: In some European countries, primary care is mainly provided by GPs in single-handed practices who work together with a nurse or receptionist, e.g. in Austria and Slovakia. However, there are also countries, such as Spain, where on average 12 GPs and more than 6 different professional groups work together. The most common non-physicians in primary care teams are practice nurses, receptionists/medical secretaries, community/home care nurses and midwives. With respect to professional groups working in rural and urban primary care practices, some countries have more diversity in urban primary care practices (Cyprus 5.6 different professional groups in urban settings vs 3.0 in rural) whereas other countries have more diversity in rural practices (Norway 1.6 in urban vs 3.2 in rural settings). Conclusion: This paper is included in the Workshop because the integration challenges facing primary care are common to all countries. Comparative analysis of the organization of primary care, and the available skill mix variation, contribute to the understanding of the limitations and opportunities of integration.
Key messages
The organizational scale of primary care and its level of integration is highly context dependent.
There is room for optimization of the primary care skill mix in many countries.