Strength of primary care service delivery: a comparative study of European countries, Australia, New Zealand, and Canada

Pavlič, Danica Rotar; Sever, Maja; Klemenc–Ketiš, Zalika; Švab, Igor; Vainieri, Milena; Seghieri, Chiara; Maksuti, Alem

doi:10.1017/s1463423617000792

Cited by 22 publications

(16 citation statements)

References 18 publications

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“…And in order to deliver integrated services, with provision of both health promotion and prevention within PC, health systems should adopt innovative eHealth solutions [30]. In this respect, also, relevantly, some results [68,94] show how healthcare expenditure (that could sustain technological innovation) in European countries is significantly linked to the strength of PC process. It is also to highlight that when countries decentralize important PC functions, this might lead to a not "clear governmental vision" regarding the future direction of PC ( [95], p. 171).…”

Section: Discussionmentioning

confidence: 99%

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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Introduction. eHealth applications have the potential to provide new integrated care services to patients with multimorbidity (MM), also supporting multidisciplinary care. The aim of this paper is to explore how widely eHealth tools have been currently adopted in integrated care programs for (older) people with MM in European countries, including benefits and barriers concerning their adoption, according to some basic health system characteristics. Materials and Methods. In 2014, in the framework of the ICARE4EU project, expert organizations in 24 European countries identified 101 integrated care programs. Managers of the selected programs completed an online questionnaire on several dimensions, including the use of eHealth. We analyzed data from this questionnaire, in addition to qualitative information from six innovative programs which were studied in depth through case study methodology, according to characteristics of national health systems: a national health model (financing system), overall strength of primary care (PC) (structure/service delivery process), and level of (de)centralization of health system (executive powers in a country). Results. 85 programs (out of 101) adopted at least one eHealth tool, and 42 of these targeted explicitly older people. In most cases, Electronic Health Records (EHRs) were used and some benefits emerged like improved care management and integration, although inadequate funding mechanisms represented a major barrier. The analysis by health system characteristics showed a greater adoption of eHealth applications in decentralized countries, in countries with a National Health Service (NHS) model, and in countries with a strong/medium level of PC development. Conclusions. Although in the light of some limitations, findings indicate a relation between implementation of care programs using eHealth tools and basic characteristics of health systems, with decentralization of a health system, NHS model, and strong/medium PC having a key role. However adaptations of European health systems seem necessary, in order to provide a more innovative and integrated care.

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Section: Discussionmentioning

confidence: 99%

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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“…In countries that had a highest expenditure for healthcare per capita -Luxembourg, Norway, Netherlands the morbidity and mortality for cardiovascular diseases's is significantly lower than in Poland. 10,12 We found out that the respiratory system diseases affect 42% of patients. In 2014 respiratory system diseases were causes of 20 000 deaths in Poland.…”

Section: Discussionmentioning

confidence: 97%

“…13 In Luxembourg, where expenses for healthcare are higher than in Poland, the death rates are slightly lower. 12,13 Also, the influenza in Poland has the lowest standardized death rates, and is not recognizable in the GP's office. 13 Comparing the most commonly occurring diagnosis and medical problems in GP's obtained by our analysis in Poland and compared to data presented by Australians, top 30 is slightly different.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of the prevalence of diseases in the rural areas of Warmia and Mazury

et al. 2019

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Int roduc t ion: General practitioners (GPs), are the foreground of all medicine. When a disease starts, most patients have their first contact with medicine in the GP’s offices. For this reason, it is likely that the illnesses diagnosed by GPs are consistent with the real number of illnesses occurring in the area of their region. Aim: To preset in this research we focused on the frequency of cases of disease where there was a problem with receiving prompt medical advice. Ma t e r i a l and me thods : We obtained data of 14 279 visits of 2774 patients from January 1 to December 31, 2017, containing an ICD-10 diagnosis, the statistical number of the patient and the patient’s age at the time of visit from the 3 GPs facilities belonging to one practice in a rural area near to Olsztyn. Re sul t s and di s cus s ion: Analysis has shown that the most popular cardiovascular system disease is essentially hypertension. We found out that hypertension was affecting even the youngest people – males from 20 to 30 years old. Under the age group of 40–50 years old, mainly men suffered from hypertension. The family doctor institution should be the basis of the Polish Health System. It is the place where all the patients’ basic needs should be met. This institution should be the first filter of patients, which refers patients to more highly-specialistic medical providers. Conc lus ions : The top 15 diagnoses in our study contains prescribing medication, which is the same in Australia.The difference between the two countries is the percentage of this problem – 24.1% in Polish GPs vs. 1.6% in Australian GPs.

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“…There are similar initiatives in Hungary as well [24]. Continuity and comprehensiveness of care are closely linked to national healthcare expenditures; however, coordination of care is not [27].…”

Section: Price Of the Prescriptions Become An Issue For The Hungarianmentioning

confidence: 99%

Evaluation of primary care services in Hungary

Rurik

Jancsó

Kalabay

et al. 2020

Preprint

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Background. It is a major challenge to show what configurations of primary care(PC) is associated with better outcomes, in terms of quality, equity and costs. The QUALICOPC Study tried to analyse and compare them within 35 countries, using validated questionnaires filled by family physicians/general practitioners (GPs). This paper aims to provide data of the Hungarian-arm of the QUALICOPC Study; to compare some findings to that of other participating countries; to give a comprehensive overview about the recent Hungarian PC system. Methods. Altogether 222 questionnaires were completed by Hungarian GPs, delivered by fieldworkers, in a geographically representative distribution. Results . Financing are based mostly on capitation, with smaller additional compensatory elements and minor quality incentives. The gate-keeping function is weak, although by referrals, the preference of patients is mostly considered. Communication between PC and specialists is often insufficient. Variety of available devices and equipment’s are appropriate. Single handed practices were 87%. Appointment instead of queuing is a new option and become more popular, mainly among better educated and urban patients. GPs are involved in the management of almost all chronic condition of all generations. Half of them estimate their job as still interesting, burn-out symptoms were rarely found. Among the evaluated process indicators, access, continuity, comprehensiveness and coordination were rated as satisfactory, together with equity among health outcome indicators. Financing is not sufficient, therefore many GPs are involved in other earning activities. The increasing shortage of manpower is a major challenge. Conclusions. In the past 2 decades, there was visible improvement at service level and in economic circumstances. Cooperation and communication between different levels of health care provision should be improved, focusing better to community orientation and to preventive services. There is a need for specific primary care oriented guidelines to define the expected tasks of GPs.

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Strength of primary care service delivery: a comparative study of European countries, Australia, New Zealand, and Canada

Cited by 22 publications

References 18 publications

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Analysis of the prevalence of diseases in the rural areas of Warmia and Mazury

Evaluation of primary care services in Hungary

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