eupha 2010 pc related conditions and mechanisms for care ... · spain finland united kingdom italy...

EUPHA Conference12 November 2010, Amsterdam

PC-related conditions and mechanismsfor care coordination in Europe

NIVEL-Netherlands Institute for Health Services Researchwww.nivel.eu / www.phameu.eu

Wienke Boerma, Dionne Sofia Kringos, Jasper van Riet Paap

On behalf of the PHAMEU Consortium


CONSORTIUM- NIVEL (coordinator)- University of Tartu (EE) - IRDES (F)- Heinrich Heine University (DE)- University Witten/Herdecke- Bocconi University (I)- University of Tromso (N)- Jagiellonian University (PL)- University of Ljubljana (SV)- IDIAP Jordi Gol (ES)- Sheffield University (UK)- University of Leicester (UK)- WHO Europe- European Forum for PC- EUPHA- EGPRNFunded by European Commission


METHODS1) PC Monitoring Instrument2) Data collection in 31

countries

International statistical datasets

National statistical datasets

Policy documents

Published literature

Expert enquiriesUse of networks, incl:

National PC expertsWHO-EuroEUPHAEuropean Forum for PC EGPRN


Systematic literature review- key PC dimensions- relevance for health (system) outcomes- identification of PC indicators- expert consultation round

METHOD for Instrument Development

Kringos et al. The breadth of primary care: a systematic literature review of its core dimensions . BMC Health Services Research 10:65


PRIMARY CARE SYSTEM FRAMEWORKDimensions of the PC structure

Governance of PC system

Economic conditions of PC system

PC Workforce development

Dimensions of PC outcomes

Quality of PC Efficiency of PC

Dimensions of the PC Process

Access to PC services

Comprehensiveness of PC services

Continuity of PC Coordination of PC


Indicators on coordinationPatients registered with a GP

Population per GP

GP-specialist ratio

Scale of GP/PC practice

Meetings with PC providers

Asking advice from med. Specialists

(Patients’ trust)


AustriaBelgiumSwitzerlandCyprusGermanyFranceLuxemburgMalta

LithuaniaLatviaNetherlandsNorwayPolandRomaniaSloveniaSlovakiaTurkeySlovakia

BulgariaCzech RepublicDenmarkEstoniaSpainFinlandUnited KingdomIrelandIcelandItaly

20 8

Not registered(‘NO LIST’)

Registered with GP(‘LIST’)

Patients registered with a GP


GP density (population per GP)

AustriaGermanyMalta

BelgiumFranceLuxemburg

NO LIST

8107

FinlandNetherlandsRomaniaSlovakiaTurkey

BulgariaCzech RepublicDenmarkEstoniaUnited KingdomIrelandIcelandLithuaniaLatviaSlovenia

SpainItalyNorwayPoland

LIST

High>1825

Medium1550-1825

Low<1550

Systemswith:


GP-specialist ratio (GP/Spec)

LuxemburgAustriaBelgiumSwitzerlandGermanyFranceMalta

NO LIST

818

DenmarkFinlandIrelandItalyNetherlandRomaniaTurkey

BulgariaCzech RepublicEstoniaSpainUnited KingdomIcelandLithuaniaLatviaNorwayPolandSloveniaSlovakia

LIST

High>.43

Low<.43

Systemswith:


Dominant mode of practice:

Single handed

GPs group practiceGPs+Spec practiceNo data

Scale of GP practice


SwitzerlandLuxemburgMaltaBelgium

AustriaCyprusGermanyFrance

NO LIST

3157

IrelandIcelandLithuania

BulgariaCzech RepublicEstoniaSpainFinlandUnited KingdomItalyNetherlandsPolandSloveniaTurkey

DenmarkLatviaSlovakia

LIST

Often meetOccasionally meet

Seldom or never meet

Systemswith:

GPs meeting with other PC providers


BelgiumSwitzerland

AustriaGermanyFranceLuxemburg, Malta

NO LIST

1418

NetherlandsLithuaniaNorway

BulgariaCzech RepublicEstoniaIrelandIcelandSpainFinlandUnited KingdomItalyPolandSloveniaSlovakiaTurkey

LIST

(Very) common

UsualRareSystemswith:

GPs asking advice from medical specialists


GermanyCyprus

BelgiumNO LIST

827

EstoniaIrelandSpainNorwayUnited Kingdom

SlovakiaBulgariaFinlandLithuaniaLatviaNetherlandsRomaniaTurkey

LIST

>90%75-90%<75%Systemswith:

Patients’ trust in GPs


CONCLUSION ON PHAMEU

Good starting point for a comprehensive European PC database

Variation in availability and quality of data

Comparability of data

Intra-country variation (regions)

CONCLUSION ON COORDINATION

Conditions favourable in most countries

Much can be improved in daily practice

Coordination and patient satisfaction not parallel

eupha 2010 pc related conditions and mechanisms for care ... · spain finland united kingdom italy...

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