Re-thinking performance assessment for primary care: opinion of the Expert Panel on Effective Ways of Investing in Health

Dionne Kringos, Sabina Nuti, Luigi Siciliani, Christian Anastasy, Margaret Barry, Liubove Murauskiene, Jan de Maeseneer

Research output: Contribution to journalArticlepeer-review


Background: In 2017, the European Commission (EC) identified as a policy priority the performance assessment of primary care systems, which relates to a country’s primary care structure, services delivery and outcomes. The EC requested its Expert Panel on Effective Ways of Investing in Health (Expert Panel) to provide an opinion on ways for improving performance assessment of primary care. Objectives: To provide an overview of domains and dimensions to be taken into consideration in assessing primary care and specific indicators to be collected and analysed to improve understanding of primary care performance. Methods: A sub-group of the Expert Panel performed a literature review. The opinion was drafted, improved and approved through working-group discussions, consultations with the EC, the Expert Group on Health Systems Performance Assessment, and a public hearing. Results: Drawing on the main characteristics of primary care, we propose essential elements of a primary care performance assessment system based on specific indicators. We identified ten domains with accompanying dimensions for which comparative key indicators and descriptive indicators are proposed: (1) universal and accessible care, (2) integrated, (3) person-centred, (4) comprehensive and community-oriented care, (5) provided by a team accountable for addressing a vast majority of personal health needs, (6) sustained partnership with patients and informal caregivers, (7) coordination, (8) continuity of care, (9) primary care organization, and (10) human resources. Conclusion: The identified characteristics and criteria for development of a primary care performance assessment system provides a starting point for strengthening the coherence of assessment frameworks across countries and exchanging best practices.

Original languageEnglish
Pages (from-to)55-61
Number of pages7
JournalEuropean Journal of General Practice
Issue number1
Early online date12 Dec 2018
Publication statusPublished - 2 Jan 2019

Bibliographical note

© 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


  • Primary care
  • health information
  • health systems
  • indicators
  • performance assessment

Cite this