Living In A Country With A Strong Primary Care System Is Beneficial To People With Chronic Conditions.
In light of the growing pressure that multiple chronic diseases place on health care systems, we investigated whether strong primary care was associated with improved health outcomes for the chronically ill. We did this by combining country- and individual-level data for the twenty-seven countries of the European Union, focusing on people's self-rated health status and whether or not they had severe limitations or untreated conditions. We found that people with chronic conditions were more likely to be in good or very good health in countries that had a stronger primary care structure and better coordination of care. People with more than two chronic conditions benefited most: Their self-rated health was higher if they lived in countries with a stronger primary care structure, better continuity of care, and a more comprehensive package of primary care services. In general, while having access to a strong primary care system mattered for people with chronic conditions, the degree to which it mattered differed across specific subgroups (for example, people with primary care-sensitive conditions) and primary care dimensions. Primary care reforms, therefore, should be person centered, addressing the needs of subgroups of patients while also finding a balance between structure and service delivery.
Johan Hansen (j.hansen@nivel.nl) is a postdoctoral senior researcher at the Netherlands Institute for Health Services Research (NIVEL), in Utrecht.
Johan
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Hansen
Peter P. Groenewegen is director of NIVEL and a professor of social and geographical aspects of health and health care at Utrecht University.
Peter P
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Groenewegen
Wienke G. W. Boerma is a postdoctoral senior researcher at NIVEL.
Wienke G W
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Boerma
Dionne S. Kringos is a postdoctoral senior researcher at the Academic Medical Centre of the University of Amsterdam, in the Netherlands, and a 2014-15 Harkness Fellow in Healthcare Policy and Practice at the Harvard T. H. Chan School of Public Health, in Boston, Massachusetts.
Dionne S
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Kringos
D000328:Adult; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease / Q000628:therapy*; D016208:Databases, Factual; D019049:Developed Countries; D005062:European Union; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000458:organization & administration*; D018570:Risk Assessment; D012737:Sex Factors
Chronic Care; Developed World < International/global health studies; Organization and Delivery of Care; Primary Care; Special Populations