EUPHA 2010 PC related conditions and mechanisms for care ... · Spain Finland United Kingdom Italy...
Transcript of 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
EUPHA Conference12 November 2010, Amsterdam
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
EUPHA Conference12 November 2010, Amsterdam
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
EUPHA Conference12 November 2010, Amsterdam
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
EUPHA Conference12 November 2010, Amsterdam
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
EUPHA Conference12 November 2010, Amsterdam
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)
EUPHA Conference12 November 2010, Amsterdam
AustriaBelgiumSwitzerlandCyprusGermanyFranceLuxemburgMalta
LithuaniaLatviaNetherlandsNorwayPolandRomaniaSloveniaSlovakiaTurkeySlovakia
BulgariaCzech RepublicDenmarkEstoniaSpainFinlandUnited KingdomIrelandIcelandItaly
20 8
Not registered(‘NO LIST’)
Registered with GP(‘LIST’)
Patients registered with a GP
EUPHA Conference12 November 2010, Amsterdam
GP density (population per GP)
AustriaGermanyMalta
BelgiumFranceLuxemburg
NO LIST
8107
FinlandNetherlandsRomaniaSlovakiaTurkey
BulgariaCzech RepublicDenmarkEstoniaUnited KingdomIrelandIcelandLithuaniaLatviaSlovenia
SpainItalyNorwayPoland
LIST
High>1825
Medium1550-1825
Low<1550
Systemswith:
EUPHA Conference12 November 2010, Amsterdam
GP-specialist ratio (GP/Spec)
LuxemburgAustriaBelgiumSwitzerlandGermanyFranceMalta
NO LIST
818
DenmarkFinlandIrelandItalyNetherlandRomaniaTurkey
BulgariaCzech RepublicEstoniaSpainUnited KingdomIcelandLithuaniaLatviaNorwayPolandSloveniaSlovakia
LIST
High>.43
Low<.43
Systemswith:
EUPHA Conference12 November 2010, Amsterdam
Dominant mode of practice:
Single handed
GPs group practiceGPs+Spec practiceNo data
Scale of GP practice
EUPHA Conference12 November 2010, Amsterdam
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
EUPHA Conference12 November 2010, Amsterdam
BelgiumSwitzerland
AustriaGermanyFranceLuxemburg, Malta
NO LIST
1418
NetherlandsLithuaniaNorway
BulgariaCzech RepublicEstoniaIrelandIcelandSpainFinlandUnited KingdomItalyPolandSloveniaSlovakiaTurkey
LIST
(Very) common
UsualRareSystemswith:
GPs asking advice from medical specialists
EUPHA Conference12 November 2010, Amsterdam
GermanyCyprus
BelgiumNO LIST
827
EstoniaIrelandSpainNorwayUnited Kingdom
SlovakiaBulgariaFinlandLithuaniaLatviaNetherlandsRomaniaTurkey
LIST
>90%75-90%<75%Systemswith:
Patients’ trust in GPs
EUPHA Conference12 November 2010, Amsterdam
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