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Euprimecare: Quality and Costs of Primary Care in Europe Carlos Segovia. Instituto de Salud Carlos III. Budapest, 3.06.11 Grant Agreement no. 241595
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EUprimecare: Quality & costs of primary care in Europe Objectives: To define and describe primary care modelsWP2 To estimate the costs in each modelWP3&4 To assess quality in each modelWP5&6 To describe possible trade-offs between quality & costs WP7 To disseminate resultsWP8 WP1 WP2 WP8 Management models dissemination WP3&4 costs WP5&6 WP7 quality trade-offs so far
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EUprimecare: Quality & costs of primary care in Europe Partners: Bocconi University, Italy Institute of Health Carlos III, ISCIII, Spain Institute of Health & Welfare, THL, Finland Kaunas University of Medicine, Lithuania National Institute for Strategic Health Research, ESKI, Hungary National Institute of Primary Care, OALI, Hungary University of Bielefeld, Germany University of Tartu, Estonia
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EUprimecare: Quality & costs of primary care in Europe Models: Based on Roberts, Hsiao, Berman, Reich (2004). Control knobs: Financing, Organization, Payment, Regulation, Behaviour 1 Review literature and collect data about relevance of control knobs and their shape in 7 participating countries + up to 50 from HiT reports 2 Identify forms of the control knobs that usually go together Functional analysis Statistical analysis 3 Define models
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EUprimecare: Quality & costs of primary care in Europe Models so far: 5 functional models (countries in EUprimecare): Model 1: Direct access to any GP or specialist (Germany) Model 2: Referral required from GP, mainly solo-practices in PHC (Hungary, Italy) Model 3: Referral required from GP, mainly group-practices in PHC (Estonia, Lithuania) Model 4: GPs working mainly in health care centres (Finland, Spain) Model 5: Polyclinics (Shemasko). Not necessarily GPs at all 53 countries analysed and ascribed to one model (some more than one) Statistical principal component analysis – relevant variables: Private voluntary health insurance Geographic distribution of PC Payment method Gatekeeping Solo or group practice Quality management programmes
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EUprimecare: Quality & costs of primary care in Europe Costs: So far, defining methodology Macrocosts Collect information available at national or regional level Different accounting systems Microcosts Describe common cases in vignettes to identify common practice and associated cost elements and prices
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EUprimecare: Quality & costs of primary care in Europe Quality: So far, defining methodology Literature review Patients and professionals focus groups to identify sensitive and relevant criteria, done Selection of criteria of quality related to different dimensions and of indicators Patient perspective (~ 20 indicators) Technical quality (~ 16 indicators) recommended for huge groups of population Preventive measures / Screening / Chronic diseases Indicators suitable to be measured by population survey Definition of additional indicators to be measured by audit of clinical records(4 participating countries)
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EUprimecare: Quality & costs of primary care in Europe Contact and questions are welcome! http://www.euprimecare.eu/ info@euprimecare.eu Antonio Sarria: asarria@isciii.esasarria@isciii.es Carlos Segovia: csegovia@isciii.escsegovia@isciii.es
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