Coordination and Integration in European Primary Care

Wienke G. W. Boerma
Open University Press, 2006

This is chapter one of Primary Care in the Driver's Seat? Organizational Reform in European Primary Care, a volume in the European Observatory on Health Systems and Policies Series published by Open University Press. Primary Care in the Driver's Seat? explores the different approaches to primary care found across Europe and examines the success of different strategic alternatives in its design and operation. In this introductory chapter, the conceptual stage is set for the more detailed assessments that follow. It begins by examining the central issue of health system coherence and coordination, and assessing the role that primary care might play in resolving this dilemma.

From the Forward:

"This study serves as a status report on this process of organizational change. Drawing on a broad range of information and perspectives, it charts primary care’s progress to date in achieving what are important health policy objectives for all of Europe’s health care systems. This progress is particularly notable in the recent rapid proliferation of innovative mechanisms such as care networks for the chronically ill and the elderly, and continuing experimentation with new funding instruments to support and extend these networks.

The assessment provided in this volume closely follows the view of many national policy-makers that Europe is in a period of extensive innovation in primary care. This intellectual and organizational ferment, if sustained, can help close the gap between the expectations of health policy-makers about the major role that primary care should play, on the one hand, and the day-to-day performance of real health systems, on the other hand."

— Marc Danzon, WHO Regional Director for Europe

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