Developing measures to capture the true value of primary care

Tim C Olde Hartman; Andrew Bazemore; Rebecca Etz; Ryuki Kassai; Michael Kidd; Robert L Phillips Jr; Martin Roland; Kees van Boven; Chris van Weel; Felicity Goodyear-Smith

doi:10.3399/BJGPO.2020.0152

Developing measures to capture the true value of primary care

BJGP Open. 2021 Apr 26;5(2):BJGPO.2020.0152. doi: 10.3399/BJGPO.2020.0152. Print 2021 Apr.

Authors

Affiliations

¹ Radboud Institute of Health Sciences, Department of Primary and Community Care, Radboud University Nijmegen, Nijmegen, The Netherlands tim.oldeHartman@radboudumc.nl.
² SVP for Research & Policy, American Board of Family Medicine; Co-Director, Center for Professionalism & Value in Healthcare, Lexington, USA.
³ Larry A Green Center for the Advancement of Primary Health Care for the Public Good and Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
⁴ Department of Community and Family Medicine, Fukushima Medical University, Fukushima, Japan.
⁵ Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
⁶ Center for Professionalism and Value in Health Care, American Board of Family Medicine Foundation, Washington DC, USA.
⁷ University of Cambridge, Department of Public Health and Primary Care, Cambridge, UK.
⁸ Radboud Institute of Health Sciences, Department of Primary and Community Care, Radboud University Nijmegen, Nijmegen, The Netherlands.
⁹ Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand.

Abstract

Primary care (PC) is an essential building block for any high quality healthcare system, and has a particularly positive impact on vulnerable patients. It contributes to the overall performance of health systems, and countries that reorient their health system towards PC are better prepared to achieve universal health coverage. Monitoring the actual performance of PC in health systems is essential health policy to support PC. However, current indicators are often too narrowly defined to account for quality of care in the complex populations with which PC deals. This article reviews a number of conceptual frameworks developed to capture PC values in robust measures and indicators that can inform policy and practice performance. Each have benefits and limitations. Further work is needed to develop meaningful primary health care (PHC) and PC measures to inform strategic action by policymakers and governments for improved overall performance of health systems.

Keywords: delivery of health care; health policy; measures; primary health care; universal health coverage.