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Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries

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Date
2013
Dewey
Economie sociale
Sujet
Primary care; International comparison; Health policy
JEL code
I11; I18
Journal issue
Health Policy
Volume
113
Number
1-2
Publication date
2013
Article pages
170-179
Publisher
Elsevier
DOI
http://dx.doi.org/10.1016/j.healthpol.2013.05.024
URI
https://basepub.dauphine.fr/handle/123456789/12226
Collections
  • LEDa : Publications
Metadata
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Author
Groenewegen, Peter P.
Dourgnon, Paul
Gress, Stefan
Jurgutis, Arnoldas
Willems, Sara
Type
Article accepté pour publication ou publié
Abstract (EN)
European health care systems are facing diverse challenges. In health policy, strong primary care is seen as key to deal with these challenges. European countries differ in how strong their primary care systems are. Two groups of traditionally weak primary care systems are distinguished. First a number of social health insurance systems in Western Europe. In these systems we identified policies to strengthen primary care by small steps, characterized by weak incentives and a voluntary basis for primary care providers and patients. Secondly, transitional countries in Central and Eastern Europe (CCEE) that transformed their state-run, polyclinic based systems to general practice based systems to a varying extent. In this policy review article we describe the policies to strengthen primary care. For Western Europe, Germany, Belgium and France are described. The CCEE transformed their systems in a completely different context and urgency of problems. For this group, we describe the situation in Estonia and Lithuania, as former states of the Soviet Union that are now members of the EU, and Belarus which is not. We discuss the usefulness of voluntary approaches in the context of acceptability of such policies and in the context of (absence of) European policies.

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