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Political, cultural and economic foundations of primary care in Europe

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  • Kringos, Dionne S.
  • Boerma, Wienke G.W.
  • van der Zee, Jouke
  • Groenewegen, Peter P.

Abstract

This article explores various contributing factors to explain differences in the strength of the primary care (PC) structure and services delivery across Europe. Data on the strength of primary care in 31 European countries in 2009/10 were used. The results showed that the national political agenda, economy, prevailing values, and type of healthcare system are all important factors that influence the development of strong PC. Wealthier countries are associated with a weaker PC structure and lower PC accessibility, while Eastern European countries seemed to have used their growth in national income to strengthen the accessibility and continuity of PC. Countries governed by left-wing governments are associated with a stronger PC structure, accessibility and coordination of PC. Countries with a social-security based system are associated with a lower accessibility and continuity of PC; the opposite is true for transitional systems. Cultural values seemed to affect all aspects of PC. It can be concluded that strengthening PC means mobilising multiple leverage points, policy options, and political will in line with prevailing values in a country.

Suggested Citation

  • Kringos, Dionne S. & Boerma, Wienke G.W. & van der Zee, Jouke & Groenewegen, Peter P., 2013. "Political, cultural and economic foundations of primary care in Europe," Social Science & Medicine, Elsevier, vol. 99(C), pages 9-17.
    • Handle: RePEc:eee:socmed:v:99:y:2013:i:c:p:9-17
    DOI: 10.1016/j.socscimed.2013.09.017
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    Cited by:

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    3. Ana Isabel Ribeiro & Elias Teixeira Krainski & Marilia Sá Carvalho & Guy Launoy & Carole Pornet & Maria de Fátima Pina, 2018. "Does community deprivation determine longevity after the age of 75? A cross-national analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 63(4), pages 469-479, May.
    4. Akman, Mehmet & Sakarya, Sibel & Sargın, Mehmet & Ünlüoğlu, İlhami & Eğici, Memet Taşkın & Boerma, Wienke G.W. & Schäfer, Willemijn L.A., 2017. "Changes in primary care provision in Turkey: A comparison of 1993 and 2012," Health Policy, Elsevier, vol. 121(2), pages 197-206.
    5. Vermeulen, Lisa & Schäfer, Willemijn & Pavlic, Danica Rotar & Groenewegen, Peter, 2018. "Community orientation of general practitioners in 34 countries," Health Policy, Elsevier, vol. 122(10), pages 1070-1077.

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