Table 9.2.

PHAMEU scoring system for the strength of the countries’ primary care system (Kringos et al., 2013).

The Structure of Primary CareThe Service-delivery Process of Primary CareOverall Primary Care System Strength
CountryPrimary Care GovernanceEconomic Conditions of Primary CarePrimary Care Workforce DevelopmentAccess to Primary CareContinuity of Primary CareCoordination of Primary CareComprehensiveness of Primary Care
AustriaMediumMediumWeakMediumWeakWeakWeakWeak
BelgiumMediumStrongMediumWeakStrongMediumStrongStrong
BulgariaMediumWeakWeakWeakMediumWeakStrongWeak
Croatia        
CyprusWeakWeakWeakWeakMediumWeakWeakWeak
Czech RepublicMediumWeakWeakStrongStrongMediumWeakMedium
DenmarkStrongMediumStrongStrongStrongStrongMediumStrong
EstoniaStrongWeakMediumMediumStrongMediumMediumStrong
FinlandMediumStrongStrongMediumMediumMediumStrongStrong
FranceMediumMediumMediumWeakMediumMediumStrongMedium
GermanyMediumStrongMediumMediumStrongWeakMediumMedium
GreeceMediumWeakWeakWeakWeakStrongWeakWeak
HungaryWeakMediumMediumStrongMediumWeakWeakWeak
IcelandWeakWeakWeakMediumStrongWeakMediumWeak
IrelandWeakWeakStrongWeakStrongWeakMediumWeak
ItalyStrongStrongMediumMediumWeakMediumWeakMedium
LatviaMediumMediumWeakWeakStrongMediumMediumMedium
LithuaniaStrongMediumMediumStrongWeakStrongStrongStrong
LuxembourgWeakWeakWeakWeakWeakMediumMediumWeak
MaltaWeakWeakStrongWeakWeakStrongMediumWeak
NetherlandsStrongStrongStrongStrongWeakStrongMediumStrong
NorwayStrongWeakMediumMediumMediumWeakStrongMedium
PolandWeakWeakWeakStrongMediumStrongWeakMedium
PortugalStrongMediumStrongStrongMediumMediumStrongStrong
RomaniaStrongStrongMediumMediumMediumWeakWeakMedium
Slovak Rep.WeakMediumWeakMediumStrongWeakWeakWeak
SloveniaStrongStrongStrongStrongWeakStrongWeakStrong
SpainStrongStrongStrongStrongStrongStrongStrongStrong
SwedenMediumMediumMediumMediumWeakStrongStrongMedium
UKStrongStrongStrongStrongMediumStrongStrongStrong

Note: Indicators making up each dimension:

Governance of the primary care system: (1) health (care) goals, (2) policy on equity in access, (3) (de)centralisation of management and service development, (4) quality management infrastructure, (5) appropriate technology, (6) patient advocacy, (7) ownership of practices and (8) integration of primary care in the healthcare system.

Economic conditions of the primary care system: (1) healthcare expenditure, (2) primary care expenditures, (3) healthcare funding system, (4) employment status of primary care workforce, (5) remuneration system of primary care workforces and (6) income of primary care workforce.

Primary care workforce development: (1) profile of workforce, (2) recognition and responsibilities of disciplines, (3) education and retention, (4) professional associations, (5) academic status of primary care disciplines and (6) future development of workforce.

Access to primary care services: (1) availability of primary care services, (2) geographic access, (3) accommodation of accessibility (including physical access), (4) affordability, (5) acceptability, (6) utilisation and (7) equality in access.

Continuity of care: (1) longitudinal, (2) informational, (3) relational and (4) management.

Coordination of care: (1) gatekeeping system, (2) practice and team structure, (3) skill-mix in primary care, (4) integration of primary and secondary care and (5) integration of primary and public health.

Comprehensiveness of care: (1) medical equipment available, (2) first contact for common health problems, (3) treatment and follow-up of diseases, (4) medical technical procedures and preventive care, (5) mother/child/reproductive health care and (6) health promotion.

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