Management in Health, Vol 18, No 1 (2014)

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A LOOK INTO PRIMARY CARE ACROSS MIDDLE INCOME COUNTRIES IN EUROPE AND CENTRAL ASIA

Andreea Cassandra BUTU, Andrada TOMOAIA-COTISEL

Abstract


BACKGROUND: In September 2012, the 53 member states of the World Health Organization (WHO) European Region adopted a new strategic framework of health policies called Health 2020. WHO in collaboration with the Netherlands Institute for Health Services Research (NIVEL) developed a tool for the evaluation of the primary care from a  health system’s perspective: the Primary Care Evaluation Tool (PCET).

METHOD:The PCET has been administered in nine countries. It consists of three structured questionnaires: one captures the national level structure, context and status of primary care, the second captures the primary care physician perspective and the third captures the patient perspective. The patient and physician surveys are administered to capture a nationally representative sample. We use this publically available data compare primary care in these areas.

RESULTS: Primary care varies across these nine cases. Five of the nine cases have a primary care department within their government. All cases have some form or primary care – however, the proportion of physicians practicing in primary care ranges from 12% in the Russian Federation to 35% in Ukraine. The percentage of patients living within 20 minutes of a primary care physician also varies. Most cases with a higher percentage of patients living within 20 minutes of a primary care physician also have a higher number of cases per primary care physician per day – the Russian Federation is a notable exception. In five of the nine cases, home visits are negatively correlated with the proportion of patients living within 20 minutes of the primary care physician. Coordination and Comprehensiveness also varies from country to country. All nine cases reported some continuity in primary care; most cases reported high longitudinal and informational continuity

CONCLUSIONS: The role and importance placed on primary care varies across the nine cases. The PCET can be used to gather information for decisions in the area of organizing primary care services.

Keywords: primary care, management, health policy, health services research, health care, health systems, Europe, Asia, middle-income countries

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Journal published by SNSPMS