Euprimecare: Quality and Costs of Primary Care in Europe Carlos Segovia. Instituto de Salud Carlos III. Budapest, Grant Agreement no

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

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

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

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

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

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)

EUprimecare: Quality & costs of primary care in Europe Contact and questions are welcome! Antonio Sarria: Carlos Segovia: