Wienke Boerma
Publicatie
Datum
11-07-2025
SiSPC, a system of indicators to characterise the strength of primary care: Report 1: development of the framework and indicators
Boerma, W.G.W., Groenewegen, P., Timans, R., Burgmann, S., Suñol, R., Illarramendi Charovsky, P., Valderas, J.M.
SiSPC, a system of indicators to characterise the strength of primary care: Report 1: development of the framework and indicators Utrecht: Nivel, 2025. 111 p.
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In this report we give account of the stepwise development of an up-to-date set of Systemic Indicators for the Strength of Primary Care, called SiSPC. Although results of research with SiSPC are extremely relevant to policy makers, the target population of this (technical) report is primarily the research community.
The development of SiSPC started from the growing awareness that a well-developed system of primary care is considered to promote the efficiency and effectiveness of health care systems overall. Particular features of primary care, like continuity and coordination across levels of care, can result in better outcomes not just in situations of complex and long-term care but also in prevention. The SiSPC indicators have been developed to compare countries on their primary care systems. We consider the strength of primary care to be a latent concept that is not directly measured, but that emerges from indicators for a mix of characteristics of primary care. Our initiative to develop an updated system of indicators arose from the need to have data available to characterise today’s primary care systems for use in international comparisons and cross-country learning. While aiming to maintain continuity, we took previous frameworks and studies as a starting point that we subsequently modified and provided with new elements. The reason to develop SiSPC was in the OECD PaRIS surveys, the international study aiming to collect and exchange information on the quality and performance of primary care from the perspective of people living with chronic conditions. However, the focus of SiSPC is broader than this category of patients as it aims to include primary care’s broad attention to prevention, treatment of both acute and chronic disease, and to people of all ages.
SiSPC data can be used in relation to the PaRIS project, carried out by an international consortium led by Nivel, to analyse survey data in participating countries. Information, gathered through SiSPC indicators about the strength of primary care systems, will be used to understand differences between countries in patient-reported experiences and outcomes as well as services offered by family physicians (FPs). SiSPC data can also be related to other outcomes, such as unmet needs or untreated conditions, or to aggregated outcomes, such as the incidence of primary care sensitive conditions or the use of hospital emergency departments.
This report details each step the research team has made to arrive at the SiSPC indicator system. Readers may want to focus on particular steps only, rather than reading the report from cover to cover. The main interest is likely to go to the finish of the voyage: the final system of indicators and how these are measured, which is presented in Chapter 7.
The development of SiSPC started from the growing awareness that a well-developed system of primary care is considered to promote the efficiency and effectiveness of health care systems overall. Particular features of primary care, like continuity and coordination across levels of care, can result in better outcomes not just in situations of complex and long-term care but also in prevention. The SiSPC indicators have been developed to compare countries on their primary care systems. We consider the strength of primary care to be a latent concept that is not directly measured, but that emerges from indicators for a mix of characteristics of primary care. Our initiative to develop an updated system of indicators arose from the need to have data available to characterise today’s primary care systems for use in international comparisons and cross-country learning. While aiming to maintain continuity, we took previous frameworks and studies as a starting point that we subsequently modified and provided with new elements. The reason to develop SiSPC was in the OECD PaRIS surveys, the international study aiming to collect and exchange information on the quality and performance of primary care from the perspective of people living with chronic conditions. However, the focus of SiSPC is broader than this category of patients as it aims to include primary care’s broad attention to prevention, treatment of both acute and chronic disease, and to people of all ages.
SiSPC data can be used in relation to the PaRIS project, carried out by an international consortium led by Nivel, to analyse survey data in participating countries. Information, gathered through SiSPC indicators about the strength of primary care systems, will be used to understand differences between countries in patient-reported experiences and outcomes as well as services offered by family physicians (FPs). SiSPC data can also be related to other outcomes, such as unmet needs or untreated conditions, or to aggregated outcomes, such as the incidence of primary care sensitive conditions or the use of hospital emergency departments.
This report details each step the research team has made to arrive at the SiSPC indicator system. Readers may want to focus on particular steps only, rather than reading the report from cover to cover. The main interest is likely to go to the finish of the voyage: the final system of indicators and how these are measured, which is presented in Chapter 7.
In this report we give account of the stepwise development of an up-to-date set of Systemic Indicators for the Strength of Primary Care, called SiSPC. Although results of research with SiSPC are extremely relevant to policy makers, the target population of this (technical) report is primarily the research community.
The development of SiSPC started from the growing awareness that a well-developed system of primary care is considered to promote the efficiency and effectiveness of health care systems overall. Particular features of primary care, like continuity and coordination across levels of care, can result in better outcomes not just in situations of complex and long-term care but also in prevention. The SiSPC indicators have been developed to compare countries on their primary care systems. We consider the strength of primary care to be a latent concept that is not directly measured, but that emerges from indicators for a mix of characteristics of primary care. Our initiative to develop an updated system of indicators arose from the need to have data available to characterise today’s primary care systems for use in international comparisons and cross-country learning. While aiming to maintain continuity, we took previous frameworks and studies as a starting point that we subsequently modified and provided with new elements. The reason to develop SiSPC was in the OECD PaRIS surveys, the international study aiming to collect and exchange information on the quality and performance of primary care from the perspective of people living with chronic conditions. However, the focus of SiSPC is broader than this category of patients as it aims to include primary care’s broad attention to prevention, treatment of both acute and chronic disease, and to people of all ages.
SiSPC data can be used in relation to the PaRIS project, carried out by an international consortium led by Nivel, to analyse survey data in participating countries. Information, gathered through SiSPC indicators about the strength of primary care systems, will be used to understand differences between countries in patient-reported experiences and outcomes as well as services offered by family physicians (FPs). SiSPC data can also be related to other outcomes, such as unmet needs or untreated conditions, or to aggregated outcomes, such as the incidence of primary care sensitive conditions or the use of hospital emergency departments.
This report details each step the research team has made to arrive at the SiSPC indicator system. Readers may want to focus on particular steps only, rather than reading the report from cover to cover. The main interest is likely to go to the finish of the voyage: the final system of indicators and how these are measured, which is presented in Chapter 7.
The development of SiSPC started from the growing awareness that a well-developed system of primary care is considered to promote the efficiency and effectiveness of health care systems overall. Particular features of primary care, like continuity and coordination across levels of care, can result in better outcomes not just in situations of complex and long-term care but also in prevention. The SiSPC indicators have been developed to compare countries on their primary care systems. We consider the strength of primary care to be a latent concept that is not directly measured, but that emerges from indicators for a mix of characteristics of primary care. Our initiative to develop an updated system of indicators arose from the need to have data available to characterise today’s primary care systems for use in international comparisons and cross-country learning. While aiming to maintain continuity, we took previous frameworks and studies as a starting point that we subsequently modified and provided with new elements. The reason to develop SiSPC was in the OECD PaRIS surveys, the international study aiming to collect and exchange information on the quality and performance of primary care from the perspective of people living with chronic conditions. However, the focus of SiSPC is broader than this category of patients as it aims to include primary care’s broad attention to prevention, treatment of both acute and chronic disease, and to people of all ages.
SiSPC data can be used in relation to the PaRIS project, carried out by an international consortium led by Nivel, to analyse survey data in participating countries. Information, gathered through SiSPC indicators about the strength of primary care systems, will be used to understand differences between countries in patient-reported experiences and outcomes as well as services offered by family physicians (FPs). SiSPC data can also be related to other outcomes, such as unmet needs or untreated conditions, or to aggregated outcomes, such as the incidence of primary care sensitive conditions or the use of hospital emergency departments.
This report details each step the research team has made to arrive at the SiSPC indicator system. Readers may want to focus on particular steps only, rather than reading the report from cover to cover. The main interest is likely to go to the finish of the voyage: the final system of indicators and how these are measured, which is presented in Chapter 7.
