PHAMEU: Primary Health Care Activity Monitor for Europe 2007-2011

Duration: Nov 2007 - Mar 2011

Background
With the accession of new Member States to the European Union and developments such as cross-border doctors' movements and patient care, there is a gradual development towards a situation where healthcare is less bound by geographical boundaries.
In light of this situation, there is a need for international comparative research that measures, records and analyzes the development, stability and especially the strength of primary care systems in Europe on a continuous basis. Primary care is generally the level where Europeans enter the health care system. A well-developed primary care system therefore has the potential, among other things, to contribute to a better health status.
The diversity of primary care in Europe provides an opportunity to explore which structures and strategies contribute to the development of a strong primary care system and the contribution of the extent of primary care development to population health, health care costs and other relevant system outcomes .

Aim
The aim of the current research is to develop a Primary Care Monitor that measures, records and compares the strength of primary care in Europe on a continuous basis. The differences between countries in the degree of development of primary care are explained. We will address the following research questions:
1. How strong are primary care systems in Europe?
2. How can differences between countries in the strength of primary care be explained?

Partners
Collaborating partners: World Health Organization Regional Office for Europe, Denmark; European General Practice Research Network, Netherlands; European Public Health Association, Netherlands; European Forum for Primary Care, Netherlands
Associated Partners:
University of Tartu (Estonia); IRDES: Institute for research and information in health economics (France); Heinrich-Heine-Universität Düsseldorf and Private Universität Witten/Herdecke gGmbH (Germany); Bocconi University (Italy); Uniwersytet Jagiellonski Collegium Medicum (Poland); University of Ljubljana (Slovenia); Fundació Jordi Gol i Gurina (Spain); University of Sheffield, Leicester University (UK); University of Tromsø (Norway).

Method
The development and implementation of the Monitor in all EU countries is carried out by a consortium of 8 institutes in as many countries, led by Nivel. The general strategy is to make as much use as possible of data that are available internationally or nationally.
In addition, own data collection will take place in each country with a network of experts.

Project design
The research group is committed to the following tasks:
- Consensus about the further implementation of the indicators, the way in which data is collected and the pattern for the database and the reports
- Developing the research tools (questionnaires and checklists); for the sake of uniformity, concepts must be clearly defined
- The actual collection of the data for the indicators. This falls into 3 groups of activities:
1. Data from the literature
2. statistical data from international and national databases
3. data collection in each of the 30 countries for information not available from the above sources, through (group) interviews with key experts.
- Description and analysis of data; resulting in structured country descriptions; international comparative overviews; trends.
- Dissemination of the results in the form of disclosure via a website; book; presentations; collaboration with international organizations such as EUPHA, European Observatory of Health Systems and Policy.
- Consolidation and continuity of the Monitor. These activities are aimed at maintaining the European network of experts and preparing the repeated applications of the Monitor.

Result
The Primary Care Monitor is a research instrument with which the state of primary care in the 27 EU countries and in Switzerland, Norway, Iceland and Turkey is mapped in a structured and uniform manner and can be monitored over time by means of repeated measurements. The Monitor's indicators cover total primary care as well as the interfaces with public health, secondary care and relevant social services. The indicators cover various aspects of primary care, such as national policy priorities, funding, organisation, tasks, the role of professionals; and the relationship with users of care. The dynamics of the Monitor lies in the attention to current events as expressed in the identified bottlenecks, policy intentions and care innovation. Because the Monitor is repeated at regular intervals, not only does the progress in primary care development become visible and the possible obstacles to it, but also information quickly becomes available about initiatives for care innovation in EU+4 Member States.