Primary care characteristics and population-orientated health care across Europe: An observational study

Jan Van Lieshout, Margalit Goldfracht, Stephen Campbell, Sabine Ludt, Michel Wensing

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background The number of patients with chronic diseases is increasing which poses a challenge to healthcare organisations. A proactive, structured, and population-orientated approach is needed: the chronic care model (CCM) provides such a framework.

Aim To assess organisational conditions for providing structured chronic care according to the CCM across different healthcare systems.

Design of study International observational study.

Setting A stratified sample of 315 primary care practices in 10 European countries and Israel in 2008 and 2009.

Method Practice questionnaires and interviews. Outcome measures were mean practice scores on CCM domains per country, as a percentage of the maximum score, and the influence of practice size and urbanisation on these scores.

Results Practice size showed large differences with the largest practices in Spain, England, Finland, and Israel. These countries, with a strong primary care orientation, had most physicians and staff involved per practice. The CCM domains ‘clinical information systems’ and ‘decision support’ had total practice means of 90%; other domains scored about 50%. Spain and England scored above average on almost all domains. Practice size and urbanisation had little impact.
Conclusion Characteristics for chronic care delivery differed for most CCM domains. The most common characteristics related to computerisation, providing a good starting point and high potential everywhere. All countries showed room for improvement. Further research should focus on relations between practice characteristics, organisational features, including health system and primary care orientation, and outcomes. Primary care seems suited for chronic care delivery; however, a stronger primary care was associated with better scores.
Original languageEnglish
Pages (from-to)22-30
Number of pages9
JournalBritish Journal of General Practice
Volume61
Issue number582
DOIs
Publication statusPublished - 2011
Externally publishedYes

Fingerprint

Population Characteristics
Observational Studies
Primary Health Care
Delivery of Health Care
Urbanization
Israel
England
Spain
Clinical Decision Support Systems
Finland
Information Systems
Chronic Disease
Outcome Assessment (Health Care)
Organizations
Interviews
Physicians
Research
Population

Cite this

Van Lieshout, Jan ; Goldfracht, Margalit ; Campbell, Stephen ; Ludt, Sabine ; Wensing, Michel. / Primary care characteristics and population-orientated health care across Europe: An observational study. In: British Journal of General Practice. 2011 ; Vol. 61, No. 582. pp. 22-30.
@article{85b6d314fdaa47e3a29e12642908ba5c,
title = "Primary care characteristics and population-orientated health care across Europe: An observational study",
abstract = "Background The number of patients with chronic diseases is increasing which poses a challenge to healthcare organisations. A proactive, structured, and population-orientated approach is needed: the chronic care model (CCM) provides such a framework.Aim To assess organisational conditions for providing structured chronic care according to the CCM across different healthcare systems.Design of study International observational study.Setting A stratified sample of 315 primary care practices in 10 European countries and Israel in 2008 and 2009.Method Practice questionnaires and interviews. Outcome measures were mean practice scores on CCM domains per country, as a percentage of the maximum score, and the influence of practice size and urbanisation on these scores.Results Practice size showed large differences with the largest practices in Spain, England, Finland, and Israel. These countries, with a strong primary care orientation, had most physicians and staff involved per practice. The CCM domains ‘clinical information systems’ and ‘decision support’ had total practice means of 90{\%}; other domains scored about 50{\%}. Spain and England scored above average on almost all domains. Practice size and urbanisation had little impact.Conclusion Characteristics for chronic care delivery differed for most CCM domains. The most common characteristics related to computerisation, providing a good starting point and high potential everywhere. All countries showed room for improvement. Further research should focus on relations between practice characteristics, organisational features, including health system and primary care orientation, and outcomes. Primary care seems suited for chronic care delivery; however, a stronger primary care was associated with better scores.",
author = "{Van Lieshout}, Jan and Margalit Goldfracht and Stephen Campbell and Sabine Ludt and Michel Wensing",
year = "2011",
doi = "10.3399/bjgp11X548938",
language = "English",
volume = "61",
pages = "22--30",
journal = "Journal of the Royal College of General Practitioners",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "582",

}

Primary care characteristics and population-orientated health care across Europe: An observational study. / Van Lieshout, Jan; Goldfracht, Margalit; Campbell, Stephen; Ludt, Sabine; Wensing, Michel.

In: British Journal of General Practice, Vol. 61, No. 582, 2011, p. 22-30.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Primary care characteristics and population-orientated health care across Europe: An observational study

AU - Van Lieshout, Jan

AU - Goldfracht, Margalit

AU - Campbell, Stephen

AU - Ludt, Sabine

AU - Wensing, Michel

PY - 2011

Y1 - 2011

N2 - Background The number of patients with chronic diseases is increasing which poses a challenge to healthcare organisations. A proactive, structured, and population-orientated approach is needed: the chronic care model (CCM) provides such a framework.Aim To assess organisational conditions for providing structured chronic care according to the CCM across different healthcare systems.Design of study International observational study.Setting A stratified sample of 315 primary care practices in 10 European countries and Israel in 2008 and 2009.Method Practice questionnaires and interviews. Outcome measures were mean practice scores on CCM domains per country, as a percentage of the maximum score, and the influence of practice size and urbanisation on these scores.Results Practice size showed large differences with the largest practices in Spain, England, Finland, and Israel. These countries, with a strong primary care orientation, had most physicians and staff involved per practice. The CCM domains ‘clinical information systems’ and ‘decision support’ had total practice means of 90%; other domains scored about 50%. Spain and England scored above average on almost all domains. Practice size and urbanisation had little impact.Conclusion Characteristics for chronic care delivery differed for most CCM domains. The most common characteristics related to computerisation, providing a good starting point and high potential everywhere. All countries showed room for improvement. Further research should focus on relations between practice characteristics, organisational features, including health system and primary care orientation, and outcomes. Primary care seems suited for chronic care delivery; however, a stronger primary care was associated with better scores.

AB - Background The number of patients with chronic diseases is increasing which poses a challenge to healthcare organisations. A proactive, structured, and population-orientated approach is needed: the chronic care model (CCM) provides such a framework.Aim To assess organisational conditions for providing structured chronic care according to the CCM across different healthcare systems.Design of study International observational study.Setting A stratified sample of 315 primary care practices in 10 European countries and Israel in 2008 and 2009.Method Practice questionnaires and interviews. Outcome measures were mean practice scores on CCM domains per country, as a percentage of the maximum score, and the influence of practice size and urbanisation on these scores.Results Practice size showed large differences with the largest practices in Spain, England, Finland, and Israel. These countries, with a strong primary care orientation, had most physicians and staff involved per practice. The CCM domains ‘clinical information systems’ and ‘decision support’ had total practice means of 90%; other domains scored about 50%. Spain and England scored above average on almost all domains. Practice size and urbanisation had little impact.Conclusion Characteristics for chronic care delivery differed for most CCM domains. The most common characteristics related to computerisation, providing a good starting point and high potential everywhere. All countries showed room for improvement. Further research should focus on relations between practice characteristics, organisational features, including health system and primary care orientation, and outcomes. Primary care seems suited for chronic care delivery; however, a stronger primary care was associated with better scores.

U2 - 10.3399/bjgp11X548938

DO - 10.3399/bjgp11X548938

M3 - Article

VL - 61

SP - 22

EP - 30

JO - Journal of the Royal College of General Practitioners

JF - Journal of the Royal College of General Practitioners

SN - 0960-1643

IS - 582

ER -