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Health Policy. 2015 Dec;119(12):1576-83. doi: 10.1016/j.healthpol.2015.08.005. Epub 2015 Aug 20.

Primary care practice composition in 34 countries.

Author information

1
NIVEL - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands; Utrecht University, Department of Human Geography, Utrecht, The Netherlands; Utrecht University, Department of Sociology, Utrecht, The Netherlands. Electronic address: p.groenewegen@nivel.nl.
2
Hochschule Fulda - University of Applied Sciences, Department of Health Sciences, Leipziger Straße 123, 36037 Fulda, Germany. Electronic address: Stephanie.Heinemann@pg.hs-fulda.de.
3
Hochschule Fulda - University of Applied Sciences, Department of Health Sciences, Leipziger Straße 123, 36037 Fulda, Germany. Electronic address: Stefan.Gress@pg.hs-fulda.de.
4
NIVEL - Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands. Electronic address: w.schafer@nivel.nl.

Abstract

Health care needs in the population change through ageing and increasing multimorbidity. Primary health care might accommodate to this through the composition of practices in terms of the professionals working in them. The aim of this article is to describe the composition of primary care practices in 34 countries and to analyse its relationship to practice circumstances and the organization of the primary care system. The data were collected through a survey among samples of general practitioners (n=7183) in 34 countries. In some countries, primary care is mainly provided in single-handed practices. Other countries which have larger practices with multiple professional groups. There is no overall relationship between the professional groups in the practice and practice location. Practices that are located further from other primary care practices have more different professions. Practices with a more than average share of socially disadvantaged people and/or ethnic minorities have more different professions. In countries with a stronger pro-primary care workforce development and more comprehensive primary care delivery the number of different professions is higher. In conclusion, primary care practice composition varies strongly. The organizational scale of primary care is largely country dependent, but this is only partly explained by system characteristics.

KEYWORDS:

Health human resource policy; International comparison; Practice composition; Primary care

PMID:
26319096
DOI:
10.1016/j.healthpol.2015.08.005
[Indexed for MEDLINE]

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