Publicatie datum

Structure and organization of primary care.

Lember, M., Cartier, T., Bourgueil, Y., Dedeu, T., Hutchinson, A., Kringos, D. Structure and organization of 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. 41-66
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The way primary care is structured establishes important conditions for both the process of care and its outcomes. In this chapter, the structure of primary care will be discussed according to three dimensions: governance, economic conditions and workforce development. Governance refers to the vision and direction of health policy, which exerts influence through regulation and advocacy as well as through collecting and using information. The economic conditions of a primary care system are dominated by the total amount spent on it and how access to care for patients is organized financially. Cost-sharing, for instance, can be a source of inequity in financial access to care. The mode of remuneration of care providers is also a relevant economic condition. Primary care professionals can be salaried or self-employed and may or may not be contracted to health services or health insurance institutions. The dimension of workforce development refers to the professional profile of primary care workers and the role they play in the health care system. The chapter will conclude with a comparison of the governance, financing and workforce development
conditions, and their interrelations, across European countries. (aut. ref.)