Definition of a frame of reference in relation to primary care with a special emphasis on financing systems and referral systems – European Commission EXpert Panel on Effective Ways of Investing in Health (EXPH) – 10 July 2014

Posted on July 22, 2014. Filed under: Health Economics, Primary Hlth Care | Tags: |

Definition of a frame of reference in relation to primary care with a special emphasis on financing systems and referral systems – European Commission EXpert Panel on Effective Ways of Investing in Health (EXPH) – 10 July 2014

“Abstract

In this opinion the Expert Panel on effective ways of investing in Health (EXPH), considers primary care to be the provision of universally accessible, integrated, person-centred, comprehensive health and community services, provided by a team of professionals accountable for addressing a large majority of personal health needs. These services are delivered in a sustained partnership with patients and informal care givers, in the context of family and community and play a central role in the overall coordination and continuity of people’s care.

The professionals active in primary care teams include, among others, dentists, dieticians, general practitioners/family physicians, nurses, occupational therapists, optometrists, pharmacists, physiotherapists, psychologists and social workers.

The Expert Panel notes that strong primary care systems contribute to equity and improved health outcomes but emphasises that primary care needs to continuously evolve if it is to respond to changing challenges in society.

A strong primary care system can be the starting point for effective referral and discharge systems, ensuring integration between different levels of care. Gate-keeping can offer advantages to patients, providers and the health system so long as important organisational and patient management factors are taken into account.

The Expert Panel emphasizes the importance of ensuring that primary care services are accessed by the population without facing financial hardship and notes that there is little evidence that user charges lead to more appropriate use and cost control. When user charges are present, there should be mechanisms to protect people with low incomes and those who regularly use health care.

European Union (EU) health systems show a trend towards blended provider payment systems in primary care, combining risk-adjusted capitation with some fee-for-service reimbursement. The Expert Panel describes factors that may contribute to the effectiveness of pay-for-performance (P4P) programs and implementation features that may weaken the effectiveness of financial incentives.

Finally, the Expert Panel formulates general research questions in relation to the development of primary care in Europe, specific research questions in relation to referral
and financing and strategic directions at different levels. ”

doi:10.2772/33238

 

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