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Primary care practice composition in 34 countries
Affiliation:1. NIVEL – Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands;2. Utrecht University, Department of Human Geography, Utrecht, The Netherlands;3. Utrecht University, Department of Sociology, Utrecht, The Netherlands;4. Hochschule Fulda – University of Applied Sciences, Department of Health Sciences, Leipziger Straße 123, 36037 Fulda, Germany;1. Department of Epidemiology & Public Health, University College Cork, Ireland;2. Centre of Health Policy and Management, Trinity College Dublin, Ireland;3. Department of Public Health, Health Service Executive South, Cork, Ireland;1. CHRU de Montpellier, départment d’endocrinologie, 34295 Montpellier cedex 5, France;2. CHRU de Montpellier, département de médecine interne, 34295 Montpellier cedex 5, France;3. CHRU de Montpellier, départment de rhumatologie, 34295 Montpellier cedex 5, France;4. Faculté de médecine de Montpellier-Nîmes, département de médecine générale, 34060 Montpellier cedex 2, France;5. CHRU de Montpellier, département de santé publique, 34295 Montpellier cedex 5, France;6. CHRU de Montpellier, département de cardiologie, 34295 Montpellier cedex 5, France;7. CHRU de Montpellier, 34295 Montpellier cedex 5, France;8. Aviitam, 34960 Montpellier cedex 2, France;9. CHRU de Nîmes, département de médecine générale, 30029 Nîmes, France;10. CHRU de Montpellier, département des maladies respiratoires et addictologie, 34295 Montpellier cedex 5, France;11. CHRU de Nîmes, département de physiologie, 30029 Nîmes, France;12. URPS Médecins, 34000 Montpellier, France;13. CHRU de Nîmes, 30029 Nîmes, France;14. Université Montpellier 1, 34090 Montpellier, France;15. CHRU de Montpellier, MACVIA-LR, contre les maladies chroniques pour un vieillissement actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, 34295 Montpellier cedex 5, France;16. Inserm U1018, 94807 Villejuif cedex, France;1. DISES, Università Politecnica delle Marche, Piazzale Martelli, 8, 60100 Ancona (AN), Italy;2. SPOCRI, Macerata University, Via Don Minzoni, 2, 62100, Macerata (MC), Italy;1. Institute for Management and Economics in Healthcare, UMIT - University for Health Sciences, Medical Informatics & Technology, 6060, Hall i.T., Austria;2. Institute of Integrated Healthcare, tirol kliniken, Innrain 98, 6020, Innsbruck, Austria;3. Austrian Association of Social Workers, Mariahilferstraße 81/I/14, 1060, Wien, Austria;4. University of Applied Sciences Upper Austria, School of Applied Health and Social Sciences, Linz, Austria;5. Emergency Department, St. Willibrord Hospital, Willibrordstraße 9, 46446, Emmerich, Germany
Abstract:Health care needs in the population change through ageing and increasing multimorbidity. Primary health care might accommodate to this through the composition of practices in terms of the professionals working in them. The aim of this article is to describe the composition of primary care practices in 34 countries and to analyse its relationship to practice circumstances and the organization of the primary care system. The data were collected through a survey among samples of general practitioners (n = 7183) in 34 countries. In some countries, primary care is mainly provided in single-handed practices. Other countries which have larger practices with multiple professional groups. There is no overall relationship between the professional groups in the practice and practice location. Practices that are located further from other primary care practices have more different professions. Practices with a more than average share of socially disadvantaged people and/or ethnic minorities have more different professions. In countries with a stronger pro-primary care workforce development and more comprehensive primary care delivery the number of different professions is higher. In conclusion, primary care practice composition varies strongly. The organizational scale of primary care is largely country dependent, but this is only partly explained by system characteristics.
Keywords:Primary care  International comparison  Practice composition  Health human resource policy
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