Primary care practice composition in 34 countries

Health Policy. 2015 Dec;119(12):1576-83. doi: 10.1016/j.healthpol.2015.08.005. Epub 2015 Aug 20.


Health care needs in the population change through ageing and increasing multimorbidity. Primary health care might accommodate to this through the composition of practices in terms of the professionals working in them. The aim of this article is to describe the composition of primary care practices in 34 countries and to analyse its relationship to practice circumstances and the organization of the primary care system. The data were collected through a survey among samples of general practitioners (n=7183) in 34 countries. In some countries, primary care is mainly provided in single-handed practices. Other countries which have larger practices with multiple professional groups. There is no overall relationship between the professional groups in the practice and practice location. Practices that are located further from other primary care practices have more different professions. Practices with a more than average share of socially disadvantaged people and/or ethnic minorities have more different professions. In countries with a stronger pro-primary care workforce development and more comprehensive primary care delivery the number of different professions is higher. In conclusion, primary care practice composition varies strongly. The organizational scale of primary care is largely country dependent, but this is only partly explained by system characteristics.

Keywords: Health human resource policy; International comparison; Practice composition; Primary care.

MeSH terms

  • Ethnicity
  • Europe
  • Global Health
  • Health Personnel / statistics & numerical data*
  • Humans
  • Primary Health Care / organization & administration*
  • Professional Practice Location*
  • Surveys and Questionnaires
  • Vulnerable Populations / psychology