GENERAL OBJECTIVES CONSORTIUM. Strategies for safeguarding & improving Access to primary care in PHAMEU countries

Transcription

1 Strategies for safeguarding & improving Access to primary care in... Dionne Sofia Kringos MSc, PhD Candidate NIVEL - Netherlands Institute for Health Services Research / CONSORTIUM - NIVEL (consortium leader) - 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 -EGPRN - European Commission GENERAL OBJECTIVES Establish information and knowledge system on the state of primary care in Europe Policy recommendations Support exchange of PC information and good practice Models of good practice Create an infrastructure for repeated application Benchmark information 31 PHAMEU countries 1) Primary Care Monitoring Instrument 2) Data collection in 31 countries Int./Nat. statistical datasets Policy documents Published literature Expert enquries Devoted network: National PC experts WHO-Euro EUPHA Eur. Forum PC EGPRN PRIMARY CARE SYSTEM MONITOR Governance of PC Economic conditions PC Workforce system of PC system development STRATEGIES FOR SAFEGUARDING AND IMPROVING ACCESS TO PC SERVICES Access GOVERNANCE ECONOMIC CONDITIONS WORKFORCE DEVELOPMENT Comprehensiveness of PC services Continuity of PC Coordination of PC ACCESS Dimensions of PC outcomes Quality of PC Efficiency of PC

2 PC Workforce Profile Countries (n=16) in which the following disciplines are directly accessible GP/FP Dentist PC/GP practice nurse peadiatrician gynaec./obstetr. midwife ophthalmologist physioth. (amb.) surgeon ENT specialist occup. ther. neurologist cardiologist internist speech ther. specialised nurse home care nurse 6 4 Severe nation wide Modest nation wide Some regions No shortage Organizational Access Arrangements Telephone (n=15) Countries with PC practices that always or usually have: (n=29) Practice website (n=) Special patient group (n=16) Appointment system (n=17)

3 h h Affordability of PC services Cost-sharing for GP care; Patient dissatisfaction PC prices Acceptability of PC services Patient satisfaction with access of PC in general Patient dissatisfaction PC prices of patients that rate GP care as NOT very or not at all affordable (yr 7) DK LU SE UK CZ CH LV EE ES AT FR PO MT NL DE LT BE SK BG IT FI HU RO TR IE PT CY GR 43 Affordability of PC services Cost-sharing for GP care; Patient dissatisfaction PC prices Acceptability of PC services Patient satisfaction with access of PC in general Patient Satisfaction with PC Access patients that find it easy to reach and gain access to GPs (Yr 7) BE MT CY AT DE ES FR IE NL IS PO CZ EE LU HU UK SI IT SK BG DK LT NO GR RO FI LV PT SE TR PC Access Scale High Low Access Accommodation of Affordability of PC accessibility* services* Overall Accessibility level Patient satisfaction with Average index PC orientation at access of PC in general score Access level EUROPE 2,8 2, 3,4 3,8 3, Mean DK 3, 4, 4, 3,7 PO 4, 1,9 3,9 4, 3,4 SI 2,6 4, 3,3 LT 3, 2,3 3,9 4, 3,3 UK 2, 3,9 4, 3,3 NL 3, 2,2 3,7 4, 3,2 IS 4, 2,9 2,7 3,2 AT 1,5 4, 4, 3,2 ES 1,5 4, 4, 3,2 BE 3, 2,3 3,4 4, 3,2 SK 1,6 3,9 4, 3,2 BG 3, 2,2 3,4 4, 3,1 CH 3, 2,4 4, 3,1 FI 3, 3,1 3,4 3, 3,1 EE 3, 1,8 3,5 4, 3,1 CZ 3, 1,8 3,4 4, 3, FR 3, 2,2 2,9 4, 3, DE 1, 4, 4, 3, HU 1, 4, 4, 3, IT 1, 4, 4, 3, SE 2, 4, 3, 3, RO 3, 1,6 3,4 4, 3, MT 3, 1, 3,4 4, 2,8 LV 3, 2, 3,2 3, 2,8 CY 1, 3, 4, 2,7 GR 1, 3, 4, 2,7 TR 2, 2, 3,4 3, 2,6 LU 1, 1, 4, 4, 2,5 PT 1,5 3, 3, 2,5 IE 1, 2,6 2,4 4, 2,5 H Average-High ig PC Access Scale High Low Access Accommodation of Affordability of PC accessibility* services* Overall Accessibility level Patient satisfaction with Average index PC orientation at access of PC in general score Access level EUROPE 2,8 2, 3,4 3,8 3, Mean DK 3, 4, 4, 3,7 PO 4, 1,9 3,9 4, 3,4 SI 2,6 4, 3,3 LT 3, 2,3 3,9 4, 3,3 UK 2, 3,9 4, 3,3 NL 3, 2,2 3,7 4, 3,2 IS 4, 2,9 2,7 3,2 AT 1,5 4, 4, 3,2 ES 1,5 4, 4, 3,2 BE 3, 2,3 3,4 4, 3,2 SK 1,6 3,9 4, 3,2 BG 3, 2,2 3,4 4, 3,1 CH 3, 2,4 4, 3,1 FI 3, 3,1 3,4 3, 3,1 EE 3, 1,8 3,5 4, 3,1 CZ 3, 1,8 3,4 4, 3, FR 3, 2,2 2,9 4, 3, DE 1, 4, 4, 3, HU 1, 4, 4, 3, IT 1, 4, 4, 3, SE 2, 4, 3, 3, RO 3, 1,6 3,4 4, 3, MT 3, 1, 3,4 4, 2,8 LV 3, 2, 3,2 3, 2,8 CY 1, 3, 4, 2,7 GR 1, 3, 4, 2,7 TR 2, 2, 3,4 3, 2,6 LU 1, 1, 4, 4, 2,5 PT 1,5 3, 3, 2,5 IE 1, 2,6 2,4 4, 2,5 H Average-High ig

4 STRATEGIES FOR SAFEGUARDING AND IMPROVING ACCESS TO PC SERVICES GOVERNANCE ECONOMIC CONDITIONS ACCESS WORKFORCE DEVELOPMENT KEY FEATURES of PC STRUCTURE GOV Features: ECO Features: WFD Features: Primary care goals PC expenditure Profile of PC workforce Policy on equality in access Health care coverage Status & Responsibilities of PC disciplines (De)centralization of PC management & service development PC Quality Management Infrastructure Patient advocacy Employment status of PC workforce Remuneration system of PC workforce Income of PC workforce PC Workforce supply and planning Academic status of PC Medical associations Multidisciplinary collaboration PC ORIENTATION at ACC-GOV-ECO-WFD level 1.7 PC orientation (low) 4 high(4) at: Access -4 Governance -4 Some regions No shortage PC supportive governmental policies Policy on equality in access Stakeholder involvement PC reforms PC coverage patients National / Geographic availability workforce Organizational accommodation of access Affordability of PC services Acceptability of PC services Final PHAMEU Results OCT Thank You PC activity database 31 country reports Fact sheets Book on the state of PC in Europe Benchmark information Models of good practice Policy briefs Policy recommendations Dionne Sofia Kringos, MSc d.kringos@nivel.nl

5 NEW EU PROJECT >>> coming soon <<< RECENTLY PUBLISHED All you want to know about managed competition in the Dutch healthcare system Downloadable version at: projects/observatory For contact at NIVEL: Willemijn Schäfer (w.schafer@nivel.nl) Dionne Kringos (d.kringos@nivel.nl) European Observatory: Ewout van Ginneken (ewout.vanginneken@tuberlin.de)