Scientific INformAtion for Policy Support in Europe
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Document "European primary care": English Abstract
The healthcare systems operating in the various member states of the European Union differ from one another quite significantly. However, all are under pressure from a number of pan-European developments and all are implementing reforms designed to ensure
that their healthcare systems are able to cope with these developments. In view of this situation and the general trend towards European integration, it is reasonable to assume
that the EU member states healthcare systems will gradually become more and more alike.

One of the respects in which the healthcare systems operating in EU member states  both old and new  differ most markedly is in terms of the organisation of primary care. As the EUs healthcare systems converge, strategic decisions will have to be made
regarding primary care.
Against this background, the Minister of Health, Welfare and Sport asked advice from the Health Council on the current level of knowledge with regard to organisation and significance of primary care. The request for advice contained three questions. In
this advisory report, compiled by a Health Council committee, the Council addresses these three questions and formulates a number of recommendations for the future. The summary provides the general answers to the questions of the Minister and five key recommendations.

Question 1: What are the defining characteristics of primary care and what is the significance of primary care for the general quality of healthcare provision?

Question 2: What differences exist internationally in terms of the organisation of primary care in relation to other forms of care, and what significance do these differences have for the general quality of healthcare provision?

Question 3: (a) Given current insights, what  in terms of the overall quality of healthcare provision  is the most desirable scenario for the development of primary care within the European Union?
(b) Taking EU law into account, which aspects of the preferred development scenario require attention?

Key recommendations
In the previous sections, a number of recommendations have been implied to various stakeholders. As key recommendations, the Committee considers the following:
" Primary care must closely follow emancipatory developments in the patients role.
Information provision, effective communication, e-health, and increasing the possibilities
for tailor-made homecare are some examples of challenges faced.
" In the interest of prevention, good navigation, continuity of care, and evaluation research, primary care teams and networks should be responsible for well-defined registered populations, with variation in size in line with population density and local problems.
" The Committee advocates close cooperation between primary care, preventive healthcare, public health and occupational health. Consideration should be given to delivery of certain public health activities in the context of primary care.
" Information on primary care must be transparent to all parties involved. Building on the example of the general practice morbidity registrations in use in many European countries, steps should be taken to improve the provision of information on other
disciplines.
" As a concrete step in the short run to strengthen primary care on a European level, with the support of the European Commission, a European forum for primary care development should be created and given the remit of:
" providing for the regular and systematic exchange of experiences and programs for innovation between patients, professionals, managers and policy-makers, and for stimulating the dissemination of best practices in primary care provision and policies;
" offering consultation and support as appropriate to any country or area that has particular problems in developing a primary care system capable of serving its intended purpose;
" designing a set of indicators for monitoring the development and quality of primary care throughout the European Union;
" promoting and coordinating international comparative research.

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