Willcox, S., Lewis, G., & Burgers, J. (2011). Strengthening Primary Care: Recent Reforms and Achievements in Australia, England, and the Netherlands. The Commonwealth Fund. Retrieved from http://www.commonwealthfund.org/Publications/Issue-Briefs/2011/Nov/Strengthening-Primary-Care-Australia-England-the-Netherlands.aspx?omnicid=20.
“ABSTRACT: Recent reforms in Australia, England, and the Netherlands have sought to enhance the quality and accessibility of primary care. Quality improvement strategies include postgraduate training programs for family physicians, accreditation of general practitioner (GP) practices, and efforts to modify professional behaviors—for example, through clinical guideline development. Strategies for improving access include national performance targets, greater use of practice nurses, assured after-hours care, and medical advice telephone lines. All three countries have established midlevel primary care organizations both to coordinate primary care health services and to serve other functions, such as purchasing and population health planning. Better coordination of primary health care services is also the objective driving the use of patient enrollment in a single general practice. Payment reform is also a key element of English and Australian reforms, with both countries having introduced payment for quality initiatives. Dutch payment reform has stressed financial incentives for better management of chronic disease.
With well-developed primary care systems that have track records of strong performance, Australia, England, and the Netherlands offer some potentially useful lessons to the United States as it implements health care reforms. This brief outlines how primary care is provided in those three countries, it evaluates data on a range of primary care system performance indicators, and it examines the three countries’ major strategies for strengthening primary care:
- Promoting coordination of care;
- Reforming primary care payment;
- Improving quality and access.
