The British journal of general practice : the journal of the Royal College of General Practitioners
-
Multicenter Study
Primary care characteristics and population-orientated health care across Europe: an observational study.
The number of patients with chronic diseases is increasing which poses a challenge to healthcare organisations. A proactive, structured, and population-orientated approach is needed: the chronic care model (CCM) provides such a framework. ⋯ Characteristics for chronic care delivery differed for most CCM domains. The most common characteristics related to computerisation, providing a good starting point and high potential everywhere. All countries showed room for improvement. Further research should focus on relations between practice characteristics, organisational features, including health system and primary care orientation, and outcomes. Primary care seems suited for chronic care delivery; however, a stronger primary care was associated with better scores.
-
Prevention has become a legal obligation for French GPs, since a law was passed in March 2002. ⋯ Sixteen preventive procedures were insufficiently performed. The more a preventive service is performed the more the gap will be explained by GPs' socioprofessional characteristics. The gap for a preventive procedure performed in 25% to 75% of cases was mainly explained by management of the medical records. A nationwide policy to improve prevention performance in general practice seems to be essential.
-
In developed countries, primary health care increasingly involves the care of patients with multiple chronic conditions, referred to as multimorbidity. ⋯ Multimorbidity is common in the population and most consultations in primary care involve people with multimorbidity. These people are less likely to receive continuity of care, although they may be more likely to gain from it.