The strength of primary care in Europe: an international comparative study

Kringos, Dionne; Boerma, W.G.W.; Bourgueil, Yann; Cartier, Thomas; Dedeu, Toni; Hasvold, Toralf; Hutchinson, Allen; Lember, Margus; Oleszczyk, Marek; Pavlič, Danica Rotar; Švab, Igor; Tedeschi, Paolo; Wilm, Stefan; Wilson, Andrew; Windak, Adam; Zee, J. van der; Groenewegen, Peter

doi:10.3399/bjgp13x674422

Cited by 334 publications

(364 citation statements)

References 16 publications

(25 reference statements)

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“…Those tasked with steering the implementation of a major component of the policy universally accepted the potentially positive impact of a health system founded on strong primary care. Despite this we find that the structure of the policymaking process itself was a significant contributing factor to policy failure, thus bridging a gap in the health policy literature and extending the findings of Kringos [36] and Kringos et al [10,11] into the factors constraining the development of optimal primary care systems.…”

Section: Resultssupporting

confidence: 57%

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Health policy and the policymaking system: A case study of primary care in Ireland

2016

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In 2001, the Irish government published a reforming policy intended to modernise and expand the delivery of primary care in Ireland. Fifteen years later, the Irish health system remains beset by problems indicative of a fragmented and underdeveloped primary care system. This case study examines the formation and implementation of the 2001 primary care policy and identifies key risk categories within the policymaking process itself that inhibited the timely achievement of policy objectives. Our methodology includes a directed content analysis of the policy formation and implementation documents and the influencing academic literature, as well as semi-structured interviews with key personnel involved in the process.We identify three broad risk categories -power, resources and capability -within the policymaking process that strongly influenced policy formation and implementation. We additionally show that the disjoint between policy formation and policy implementation was a contested issue among those involved in the policy process and provided space for these risks to critically undermine Ireland's primary care policy.

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Section: Resultssupporting

confidence: 57%

“…Despite the strong evidence in favour of primary care reform and calls by bodies such as the WHO for countries to strengthen primary care systems [9], the development, organisation and strength of primary care systems to date varies widely across countries [10,11,12].…”

Section: Literature Reviewmentioning

confidence: 99%

Health policy and the policymaking system: A case study of primary care in Ireland

2016

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“…Em contraste, em países europeus organizados por sistemas nacionais de saúde é comum que a porta de entrada seja uma unidade de atenção primária à saúde, que utiliza a prerrogativa de filtro (gatekeeper) para encaminhamento dos usuários aos demais pontos da rede, facilitando, assim, a coordenação por um médico generalista 38 .…”

Section: Tem Outras Pessoas Também Que Trabalham Em Cima Da Politicagunclassified

Gestão do cuidado integral: estudo de caso em região de saúde da Bahia, Brasil

Santos

Giovanella

2016

Cad. Saúde Pública

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Analisou-se a conformação da gestão do cuidado integral nos níveis político-institucional, organizacional e nas práticas, identificando os desafios para constituição de cuidados coordenados entre municípios e os dispositivos para integração e regulação assistencial. Trata-se de estudo de caso, com abordagem qualitativa, na região de saúde de Vitória da Conquista, Bahia, Brasil, que abrange 19 municípios. As fontes de informação foram entrevistas semiestruturadas com gestores, grupos focais com gestores, profissionais e usuários, documentos institucionais e observações. Os resultados indicaram haver insuficiência de médicos para as ações e serviços na Estratégia Saúde da Família, bem como nos serviços especializados, limitando o acesso oportuno. Havia fragmentação entre os diferentes pontos e desarticulação comunicacional na rede. Interesses privados e interferências clientelistas criavam circuitos paralelos, transformando o direito à saúde em troca de favores. Tais questões obstruem as possibilidades de coordenação do cuidado na rede intermunicipal.

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“…Ayrıca Kringos ve arkadaşları neredeyse tüm ülkelerde, kapsamlılık boyutu ile ilgili olarak birinci basamağa ait yüksek nitelikli bilgilerin eksik olduğunu bildirmişlerdir. Bu nedenle birinci basamak bilgi altyapılarının hem ulusal hem de uluslararası düzeyde gelişimini sağlayacak yatırımların acilen yapılmasını önermişlerdir [22] .…”

Section: Kapsamlılıkunclassified

Strength of primary care in Turkey

Akman¹

2014

Turk Aile Hek Derg

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The strength of primary care in Europe: an international comparative study

Abstract: BackgroundA suitable definition of primary care to capture the variety of prevailing international organisation and service-delivery models is lacking.

Cited by 334 publications

References 16 publications

Health policy and the policymaking system: A case study of primary care in Ireland

Health policy and the policymaking system: A case study of primary care in Ireland

Gestão do cuidado integral: estudo de caso em região de saúde da Bahia, Brasil

Strength of primary care in Turkey

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