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Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012

OBJECTIVE: Evidence regarding the benefits of strong primary care has influenced health policy and practice. This study focuses on changes in the breadth of services provided by general practitioners (GPs) in Europe between 1993 and 2012 and offers possible explanations for these changes. DESIGN: Da...

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Autores principales: Schäfer, Willemijn L. A., Boerma, Wienke G. W., Spreeuwenberg, Peter, Schellevis, François G., Groenewegen, Peter P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911033/
https://www.ncbi.nlm.nih.gov/pubmed/26862927
http://dx.doi.org/10.3109/02813432.2015.1132887
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author Schäfer, Willemijn L. A.
Boerma, Wienke G. W.
Spreeuwenberg, Peter
Schellevis, François G.
Groenewegen, Peter P.
author_facet Schäfer, Willemijn L. A.
Boerma, Wienke G. W.
Spreeuwenberg, Peter
Schellevis, François G.
Groenewegen, Peter P.
author_sort Schäfer, Willemijn L. A.
collection PubMed
description OBJECTIVE: Evidence regarding the benefits of strong primary care has influenced health policy and practice. This study focuses on changes in the breadth of services provided by general practitioners (GPs) in Europe between 1993 and 2012 and offers possible explanations for these changes. DESIGN: Data on the breadth of service profiles were used from two cross-sectional surveys in 28 countries: the 1993 European GP Task Profile study (6321 GPs) and the 2012 QUALICOPC study (6044 GPs). GPs’ involvement in four areas of clinical activity (first contact care, treatment of diseases, medical procedures, and prevention) was established using ecometric analyses. The changes were measured by the relative increase in the breadth of service profiles. Associations between changes and national-level conditions were examined though regression analyses. Data on the national conditions were used from various other public databases including the World Databank and the PHAMEU (Primary Health care Activity Monitor) database. SETTING: A total of 28 European countries. SUBJECTS: GPs. MAIN OUTCOME MEASURE: Changes in the breadth of GP service profiles. RESULTS: A general trend of increased involvement of European GPs in treatment of diseases and decreased involvement in preventive activities was observed. Conditions at the national level were associated with changes in the involvement of GPs in first contact care, treatment of diseases and, to a limited extent, prevention. Especially in countries with stronger growth of health care expenditures between 1993 and 2012 the service profiles have expanded. In countries where family values are more dominant the breadth in service profiles decreased. A stronger professional status of GPs was positively associated with the change in first contact care. CONCLUSIONS: KEY POINTS: Broad GP service profiles are an indicator of strong primary care in a country. It is expected that developments in the breadth of GP service profiles are influenced by various national conditions related to the urgency to reform, politics, and means. Between 1993 and 2012 the involvement of GPs in European countries in treatment of diseases increased and their involvement preventive activities decreased. The national conditions were found to be associated with changes in GPs’ involvement as first contact of care, treatment of diseases, and, to a limited extent, prevention. More specifically, in countries with a stronger growth in health care expenditures, service profiles of European GPs have expanded more in the past decades.
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spelling pubmed-49110332016-06-17 Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012 Schäfer, Willemijn L. A. Boerma, Wienke G. W. Spreeuwenberg, Peter Schellevis, François G. Groenewegen, Peter P. Scand J Prim Health Care Research Articles OBJECTIVE: Evidence regarding the benefits of strong primary care has influenced health policy and practice. This study focuses on changes in the breadth of services provided by general practitioners (GPs) in Europe between 1993 and 2012 and offers possible explanations for these changes. DESIGN: Data on the breadth of service profiles were used from two cross-sectional surveys in 28 countries: the 1993 European GP Task Profile study (6321 GPs) and the 2012 QUALICOPC study (6044 GPs). GPs’ involvement in four areas of clinical activity (first contact care, treatment of diseases, medical procedures, and prevention) was established using ecometric analyses. The changes were measured by the relative increase in the breadth of service profiles. Associations between changes and national-level conditions were examined though regression analyses. Data on the national conditions were used from various other public databases including the World Databank and the PHAMEU (Primary Health care Activity Monitor) database. SETTING: A total of 28 European countries. SUBJECTS: GPs. MAIN OUTCOME MEASURE: Changes in the breadth of GP service profiles. RESULTS: A general trend of increased involvement of European GPs in treatment of diseases and decreased involvement in preventive activities was observed. Conditions at the national level were associated with changes in the involvement of GPs in first contact care, treatment of diseases and, to a limited extent, prevention. Especially in countries with stronger growth of health care expenditures between 1993 and 2012 the service profiles have expanded. In countries where family values are more dominant the breadth in service profiles decreased. A stronger professional status of GPs was positively associated with the change in first contact care. CONCLUSIONS: KEY POINTS: Broad GP service profiles are an indicator of strong primary care in a country. It is expected that developments in the breadth of GP service profiles are influenced by various national conditions related to the urgency to reform, politics, and means. Between 1993 and 2012 the involvement of GPs in European countries in treatment of diseases increased and their involvement preventive activities decreased. The national conditions were found to be associated with changes in GPs’ involvement as first contact of care, treatment of diseases, and, to a limited extent, prevention. More specifically, in countries with a stronger growth in health care expenditures, service profiles of European GPs have expanded more in the past decades. Taylor & Francis 2016-03 2016-02-03 /pmc/articles/PMC4911033/ /pubmed/26862927 http://dx.doi.org/10.3109/02813432.2015.1132887 Text en © 2016 The Author(s). Published by Taylor & Francis. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Schäfer, Willemijn L. A.
Boerma, Wienke G. W.
Spreeuwenberg, Peter
Schellevis, François G.
Groenewegen, Peter P.
Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012
title Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012
title_full Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012
title_fullStr Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012
title_full_unstemmed Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012
title_short Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012
title_sort two decades of change in european general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911033/
https://www.ncbi.nlm.nih.gov/pubmed/26862927
http://dx.doi.org/10.3109/02813432.2015.1132887
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