Developing measures to capture the true value of primary care
Tim C olde Hartman,
Andrew Bazemore,
Rebecca Etz,
Ryuki Kassai,
Michael Kidd,
Robert L PhillipsJr,
Martin Roland,
Kees van Boven,
Chris van Weel,
Felicity Goodyear-Smith
Affiliations
Tim C olde Hartman
Radboud Institute of Health Sciences, Department of Primary and Community Care, Radboud University Nijmegen, Nijmegen, The Netherlands
Andrew Bazemore
SVP for Research & Policy, American Board of Family Medicine; Co-Director, Center for Professionalism & Value in Healthcare, Lexington, USA
Rebecca Etz
Larry A Green Center for the Advancement of Primary Health Care for the Public Good and Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
Ryuki Kassai
Department of Community and Family Medicine, Fukushima Medical University, Fukushima, Japan
Michael Kidd
Department of Family and Community Medicine, University of Toronto, Toronto, Canada
Robert L PhillipsJr
Center for Professionalism and Value in Health Care, American Board of Family Medicine Foundation, Washington DC, USA
Martin Roland
University of Cambridge, Department of Public Health and Primary Care, Cambridge, UK
Kees van Boven
Radboud Institute of Health Sciences, Department of Primary and Community Care, Radboud University Nijmegen, Nijmegen, The Netherlands
Chris van Weel
Radboud Institute of Health Sciences, Department of Primary and Community Care, Radboud University Nijmegen, Nijmegen, The Netherlands
Felicity Goodyear-Smith
Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
Primary care (PC) is an essential building block for any high quality healthcare system, and has a particularly positive impact on vulnerable patients. It contributes to the overall performance of health systems, and countries that reorient their health system towards PC are better prepared to achieve universal health coverage. Monitoring the actual performance of PC in health systems is essential health policy to support PC. However, current indicators are often too narrowly defined to account for quality of care in the complex populations with which PC deals. This article reviews a number of conceptual frameworks developed to capture PC values in robust measures and indicators that can inform policy and practice performance. Each have benefits and limitations. Further work is needed to develop meaningful primary health care (PHC) and PC measures to inform strategic action by policymakers and governments for improved overall performance of health systems.
