title: Organizational changes in the course of the PHC reform in Lithuania from 1994 to 2010.
abstract: OBJECTIVE
  To assess the organizational changes in Lithuanian Primary Health Care (PHC) in the period from 1994 to 2010, and to highlight the differences with respect to the background of family physicians, the level of urbanization and the type of PHC centers.
  
  
  METHODS
  Three cross-sectional, comparative questionnaire surveys were conducted before the start of the PHC reform (in 1994) and in the course of the PHC reform (in 2004 and 2010) in Lithuania. The anonymous questionnaires were sent by mail to district physicians (i.e. internists, who provided health care for adults, and pediatricians, who provided care for children younger than 18 years old) in 1994, and to family physicians (i.e. retrained district physicians and family physicians-graduates from residency in family medicine) in 2004 and 2010.
  
  
  RESULTS
  The differences observed in 1994 between former district physicians and those who had completed residency in family medicine, private and public PHC centers and different level of urbanization dissolved in the years of the PHC reform. Physicians' age tended to be higher in the course of the PHC reform. Numbers of patients' consultations were increasing in the period after 1994 till 2010, though numbers of CME hours and home visits were decreasing.
  
  
  CONCLUSIONS
  The idea to retrain district physicians into family physicians was a valuable decision. In the years of the PHC reform the workload of family physicians in Lithuania approached the level existing in the EU. The aging of workforce, high workload and reduction of CME hours are the major concerns for future PHC policy.
authors.affiliation: Institute for Biomedical Research of Lithuanian University of Health Sciences, Laboratory of Health Systems Research, Lithuania. ida.liseckiene@gmail.com
authors.forename: Ida
authors.initials: I
authors.lastname: Liseckiene
authors.forename: Irena
authors.initials: I
authors.lastname: Miseviciene
authors.forename: Mindaugas
authors.initials: M
authors.lastname: Dudonis
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000193:education / Q000458:organization & administration*; D005260:Female; D018166:Health Care Reform; D006801:Humans; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D009936:Organizational Innovation; D011320:Primary Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D016526:Workload / Q000706:statistics & numerical data