1 / 32

ICHPO Edinburgh 2013 Priorities for primary care in Europe: a multi-disciplinary approach

ICHPO Edinburgh 2013 Priorities for primary care in Europe: a multi-disciplinary approach Diederik Aarendonk EFPC Coördinator. Created in 2005 The European Forum for Primary Care is situated at the NIVEL institute in the Netherlands.

clancy
Télécharger la présentation

ICHPO Edinburgh 2013 Priorities for primary care in Europe: a multi-disciplinary approach

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ICHPO Edinburgh 2013 Priorities for primary care in Europe: a multi-disciplinary approach Diederik Aarendonk EFPC Coördinator

  2. Created in 2005 • The European Forum for Primary Care is situated at the NIVEL institute in the Netherlands. • Multi-professional Advisory Board with members from Belgium, UK, Italy, Sweden, France, Slovenia, Turkey, Norway, Greece, Portugal, Romania, Hungary, Latvia, Spain, Macedonia, Austria and the Netherlands. Membership network • Membership (100 institutional & 50 individual members) Members from the 3 levels: Policy, Research & Practice • Membership is multi-professional

  3. The main objectives • To provide information to and share the information between the members • Advocacy for Primary Care towards policymakers and politicians • Support to the development of research and establishment of a research agenda

  4. Why this Forum? • Dissemination of expertise and knowledge on Primary Care systems • Support to members for implementation • To show the key principles of the World Health Report 2008: “Primary Health Care Now More Than Ever”!! • universal coverage (focus of the WHR 2010) • service delivery • public policy • leadership • And its relevance in relation to the WHO/Europe emphasis on Health System initiated at the Tallinn 2008 Ministerial conference on "Health Systems, Health and Wealth”

  5. Function of Primary Care in the health care system Navigation: “Tom Tom of the care”: Searching for the appropriate level of care that is needed: Encouraging informal care/self-care, when possible Providing care when needed, Referring to medical specialist care when necessary

  6. Results of consultation by GP / Primary Care team • 82 %: treated by GP / Primary Care team • 9 %: referral to specialist • 2 %: X Ray • 2 %: laboratory • 3 %: therapy at secondary care level • 2 %: other

  7. Demand & SupplyPopulation Health Management Vulnerable elderly (65+) in Almere-Haven Expected demand for care: Diabetes Mellitus (Wijkscan.com)

  8. The patient perspective as a starting point for service delivery! Includes the following values: Accessibility Continuity of care Coordination of care Comprehensiveness of services !! Integrated and Community Oriented Primary Care including Interprofessional Collaboration

  9. Quality of primary care: messagesfor the thirdmillenium Problem versus goal oriented care Absence of disease as definedby the health care system versusMaximum desirableandachievablequalityand/or quantity of life as definedbyeachindividual Eradicationof disease , prevention of deathversus assistancein achieving a maximum individual health potential Resulting in the needforpatient/client/citizenorientationandinvolvement and even one step further: Patient/client/citizeninvolvement in the set-up of Primary Care provision

  10. Quality of primary care: messagesfor the thirdmillenium Community Oriented Primary Care

  11. Organisationaldevelopments • Multiprofessional teams: integration of care is more easy. Integrated Multi Mono Solists Populationbased professional professional Healthcare healthcare care Organisationscentreorganisation

  12. Clinicalleadershipand Operational management Selfmanagement and prevention More care standards Scope of integrated care Soloist Small group practice Caregroups Anno 2011 Caregroups with extra’s Primary Care organisationsthatdeliverintegrated care Big Primary Care organisationsthatdeliverintegrated care with backoffice Primary Care centres in the south of the Netherlands are uniting

  13. Ref: Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania; Jarusevicieneet al. BMC Family Practice 2013, 14:118

  14. Activities of the Forum: Alliance of Community Oriented Primary Care services (ACOPC) as a Working Group of the EFPC Members: Catalonia Walloon Flanders Netherlands UK Portugal France Core member of the International federation of Community Health Centres (IFCHC)

  15. Improving health and primary health care around the worldthrough Community Health Centres Learn more at: www.ifchc2013.org

  16. Objectives The core goals of the IFCHC are • to foster global collaboration in community-oriented primary health care and • to expand access to Community Health Centres as the optimal way to achieve the World Health Organization’s vision for equitable access to primary health care for all.

  17. Global Partners • Canadian Association of Community Health Centres • Twitter:@CACHC_ACCSC • Community Health Australia • Twitter:@CHCAustralia • European Forum for Primary Care • Twitter:@PrimaryCare4um • US National Association of Community Health Centers • Twitter:@NACHC

  18. Primary care developments in Europe At policy making level

  19. Page 6: "Also in the context of the demographic challenges and the pressure on age-related expenditure, reforms of healthcare systems should be undertaken to ensure cost-effectiveness and sustainability, assessing the performance of these systems against the twin aim of a more efficient use of public resources and access to high quality healthcare." Annual Growth Survey 2013; Communication from the Commission; Brussels, 28.11.2012, COM(2012) 750 final

  20. Investing in sustainable health systems combines innovative reforms aimed at improving costefficiency and reconciling fiscal consolidation targets with the continued provision of sufficient levels of public services. Page 5: "using financial incentives to encourage patients to register with a general practitioner (GP) or family doctor and using a referral system to define a cost-effective path of care: from GP, to outpatient specialist, to hospital, to emergency care, while encouraging patients to have less recourse to unnecessary care and emergency services" Suggested measures for Investing in Sustainable Health Systems two clear recommendations for Member States: • Reducing the unnecessary use of specialists and hospital care • Improving primary healthcare services “Investing in Health - Key Messages”, ; European Commission, DG Health and Consumers; February 2013 .

  21. “Efficiency gains can be made by, for example, reducing unnecessary hospitalization and use of specialists, strengthening primary care, encouraging the use of less expensive equivalent (generic) drugs, and using health technology assessment to evaluate the cost-effectiveness of health technologies as a basis for decision making.” “Investment in Health a priority in the Social Investment Package” by Ms Paola TestoriCoggi, Director General for Health and Consumers, European Commission; Health-EU newsletter 106

  22. Health 2020 –reaching higher and broader: • Going upstream to address root causes such as social determinants • Invest in public health, primary care, health protection and promotion, and disease prevention • Making the case for whole-of-government and whole-of-society approaches • Offering a framework for integrated and coherent interventions Health 2020: a new European policy framework for health and well-being; ZsuzsannaJakab, WHO Regional Director for Europe, 20 March 2013, Riga, Latvia

  23. Prof Alan Maynard, University of York: “the re-distribution of income & power of Health Professionals is key to create solutions for the future” Representatives from Greek and Irish ministries of health: emphasizing the need to invest in Primary Care. Observatory: Accessibility of vulnerable groups is key, Primary Care is key! WHO Oslo conference 17-18 April 2013, Health Systems in Times of Global Economic Crisis

  24. Primary care was associated with better population health; lower rates of unnecessary hospitalizations; and relatively lower socioeconomic inequality, Overall health expenditures were higher in countries with stronger primary care structures, perhaps because maintaining strong primary care structures is costly and promotes developments such as decentralization of services delivery. Comprehensive primary care was also associated with slower growth in health care spending. Evidence grows that strong primary care in Europe is conducive to reaching important health system goals. Europe’s Strong Primary Care Systems Are Linked To Better Population Health, But Also To Higher Health Spending. Kringos DS, Boerma WGW, Van der Zee J, Groenewegen PP; doi: 10.1377/hlthaff.2012.1242 Health Affairs April 2013 vol. 32 no. 4, pp. 686-694.

  25. Page 67: “There is some evidence that Quality and Outcomes Framework has not resulted in better access to care or interpersonal elements of care, may have negative effect on inequalities as it encourages linear care pathways and a ‘one solution fits all’ approach, and is not sufficiently responsive to local needs. It has also tended to measure treatment procedures rather than clinical outcomes. It seems that QOF may have reduced inequalities in measured outputs, but this has not translated into a reduction of inequalities in the health outcomes experienced by patients.” Working for Health Equity: The Role of Health Professionals Matilda Allen, Jessica Allen, Sue Hogarth and Michael Marmot; UCL Institute of Health Equity, Department of Epidemiology & Public Health, University College London; March 2013

  26. Conclusion (1): Europe is a natural laboratory for learning about health policies and health systems. With diverse systems to finance, provide, and govern health care across the 27 member states of the European Union and the wider European region there are many opportunities for international comparative analyses and natural experiments. Health systems and policy research in Europe: Horizon 2020 Kieran Walshe, Martin McKee, Mark McCarthy, Peter Groenewegen, Johan Hansen, JosepFigueras, Walter Ricciardi The Lancet, Early Online Publication, 18 March 2013

  27. Conclusion (2): In this respect Primary Care gets a lot of attention and is seen by Policy Makers as well as Researchers as an area with enormous potential. It is up to the Primary Care professionals to make the case In order to achieve this, the different professional groups should share their interests and strive together for a strong Primary Care movement! European Forum for Primary Care! www.euprimarycare.org

  28. Activities of the Forum: Website & Two weekly Newsflash Position Papers in development PC and Interprofessional Education Impact of continuity on quality of care within Primary Care – the perspective of preferences of citizens Conferences/workshops "Balancing the Primary Care and Secondary Care provision for more integration and better health outcomes!“ 9/10 September 2013 Istanbul, Turkey Barcelona, 1/2 Sept 2014, 5th EFPC biannual conf. Advocacy (EU, National Governments, WHO) EC Expert Panel on effective ways of investing in health EC Consultations on Health topics like NCD’s & aging Multi Country Study Visits Visits to Primary Care innovations based on WHR ‘08

  29. Advocacy (EU) European Commission Expert Panel on effective ways of investing in health • EFPC Chairman Prof Jan De Maeseneer member of the expert panel • Mandate 2: Definition of a frame of reference in relation to primary care with a special emphasis on financing systems and referral systems 1. Provide a definition of primary healthcare and community-based care 2. Identify main investigation lines to analyze financing of primary care and integrated care 3. Pronounce itself on the role of effective referral systems in ensuring integration between all levels of the health system and provision of best possible care closest to home.

  30. Advocacy (EU) European Commission Consultations on Health topics like NCD’s & aging in the framework of Healthy Aging • EU project ProFouND is to embed evidence based fall prevention programs for senior citizens at risk of falls by using effective training programs and ICT-support solutions in as many countries in Europe www.profound.eu.com • EFPC invited to EU-level stakeholder group to provide multi-professional Primary Care expertise

  31. The Future of Primary Care in Europe V V bi-annual EFPC conference1/2 September “Twinning Population Health and Primary Care”

  32. EFPC at the Web www.euprimarycare.org Webbaseddatabase on European Primary Care LinkedIn discussion group “Primary Care Forum” Currently 3500 members from all over the world Twitter: (@PrimaryCare4um) 570 followers, rapidly growing Facebook-page: Primary Care Forum

More Related