498:(ACA) into law. The law is estimated to have expanded health insurance coverage by 20 million people by early 2016 and is expected to expand health care to 34 million people by 2021. The success of the expansion of health insurance under the ACA in large measure depends on the availability of primary care physicians. The ACA has drastically exacerbated the projected deficit of primary care physicians needed to ensure care for insured Americans. According to the Association of American Medical Colleges (AAMC), without the ACA, the United States would have been short roughly 64,000 physicians by 2020; with the implementation of the ACA, it will be 91,000 physicians short. According to the AAMC's November 2009 physician work force report, nationally, the rate of physicians providing primary care is 79.4 physicians per 100,000 residents.
27:
514:
specialist colleagues. This discrepancy in pay has potentially made primary care a less attractive choice for medical school graduates. In 2015, almost 19,000 doctors graduated from
American medical schools, and only 7 percent of graduates chose a career in primary care. The average age of a primary care physician in the United States is 47 years old, and one-quarter of all primary care physicians are nearing retirement. Fifty years ago, roughly half of the physicians in America practiced primary care; today, fewer than one-third of them do.
1954:
579:
546:
could be met. Consumer surveys have found the
American public to be open to a greater role for physician extenders in the primary care setting. Policies and laws, primarily at the state level, would need to redefine and reallocate the roles and responsibilities for non-physician licensed providers to optimize these new models of care.
390:
Primary health care includes measures for the prevention, diagnosis, treatment of diseases and conditions, medical rehabilitation, monitoring the course of pregnancy, the formation of a healthy lifestyle, including reducing the level of risk factors for diseases, and sanitary and hygienic education.
490:
determined that increased demand for primary care by older, sicker patients and decreased supply of primary care practitioners has led to a crisis in primary care delivery. The research identified a set of innovations that could enhance the quality, efficiency, and effectiveness of primary care in
545:
to enhance the primary care workforce. The PPACA is projected to increase patient demand for primary care services. By adopting new patient care delivery models that include physicians working in tandem with physician assistants and nurse practitioners, the demand for future primary care services
510:
differences in salary compared to doctors that decide to specialize. A 2010 national study of physician wages conducted by the UC Davis Health System found that specialists are paid as much as 52 percent more than primary care physicians, even though primary care physicians see far more patients.
444:
Gatekeeping policies should be revisited to accommodate the government's aim to modernise the NHS in terms of giving patients more choice and facilitate more collaborative work between GPs and specialists. At the same time, any relaxation of gatekeeping should be carefully evaluated to ensure the
411:
Primary medical health care is provided by general practitioners, district general practitioners, pediatricians, district general pediatricians and general practitioners (family doctors). Primary specialized health care is provided by specialist doctors, including medical specialists from medical
323:
The basic health care unit (formerly: health care facility) is a medical entity that provides comprehensive care for people who have declared their willingness to use the services of a family doctor or another doctor who has the right to create an active list of patients. This means treatment and
509:
visits and hospital care. That said, primary care physicians are an important component in ensuring that the healthcare system as a whole is sustainable. However, despite their importance to the healthcare system, the primary care position has suffered in terms of its prestige in part due to the
327:
Since 2007, only
General Practitioners, doctors undergoing specialization in family medicine, and doctors who have previously acquired the right to create an active list due to seniority in POZ before 2007 can be doctors creating active primary care lists. The currently pending proposals of the
266:
The Hong Kong
Special Administrative Region Government's 2016 Policy Address recommended strengthening the development of primary care and establishing an electronic database of the "Primary Care Guide" to facilitate public consultation. The Department of Health developed reference profiles for
532:
The
Patient Protection Affordable Care Act contains several provisions to increase primary care capacity. These provisions are directed towards medical school graduates and include payment reform, student loan forgiveness programs, and increased primary care residency positions The PPACA also
277:
The Hong Kong Food and Health Bureau established the
Primary Healthcare Office on March 1, 2019, to monitor and supervise the development of primary health care services. In the process of developing the district health centers, regional health stations will be set up in various districts as
513:
In 2005, primary care physicians earned $ 60.48 per hour; specialists, on average earned $ 88.34. A follow-up study conducted by the UC Davis Health System found that earnings throughout the careers of primary care physicians averaged as much as $ 2.8 million less than the earnings of their
442:. In the UK, unlike many other countries, patients do not normally have direct access to hospital consultants and the GP controls access to secondary care. This practice is referred to as "gatekeeping"; the future of this role has been questioned by researchers who conclude "
270:
In 2017, the policy address recommended the establishment of a primary health care development steering committee to comprehensively review the planning of primary health care services and provide community medical services through regional medical and social cooperation.
37:
is a model of health care that supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care. It aims to optimise population health and reduce disparities across the population by ensuring that subgroups have equal access to services.
566:
in decision-making during primary care consultations has benefits. Examples of patient involvement in decision-making about their health care include patient workshops and coaching, individual patient coaching. Further research in this developing area is needed.
230:
systems, private insurance and direct payment by patients are all used, sometimes in combination. The payment system for primary care physicians also varies. Some are paid by fee-for-service and some by capitation for a list of registered patients.
160:(ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care by the reason for the patient visit. Common chronic illnesses usually treated in primary care may include, for example:
848:[Decree of the Government of the Russian Federation of October 2, 2009 No. 811 "On the Program of State Guarantees for the Provision of Free Medical Care to Citizens of the Russian Federation for 2010"] (in Russian).
296:, healthcare is a concurrent responsibility of three tiers of government. Local governments focus on the delivery of primary care (e.g. through a system of dispensaries), state governments manage the various general
865:[Resolution of the Government of the Russian Federation No. 811 of October 2, 2009 "On the Program of State Guarantees for the Provision of Free Medical Care to Citizens of the Russian Federation for 2010"].
324:
prevention of diseases, rehabilitation, as well as adjudication on the state of health. For a health care center to become a primary care provider, it must also provide care for its health visitor and midwife.
790:
328:
Ministry of Health, granting the right to create an active list to internists and pediatricians without experience of working in primary care, met with severe criticism of all family medicine organizations.
846:"ΠΠΎΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΠ΅ ΠΡΠ°Π²ΠΈΡΠ΅Π»ΡΡΡΠ²Π° Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ ΠΎΡ 2 ΠΎΠΊΡΡΠ±ΡΡ 2009 Π³. β 811 Π³. "Π ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠ΅ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΡΡ
Π³Π°ΡΠ°Π½ΡΠΈΠΉ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ Π³ΡΠ°ΠΆΠ΄Π°Π½Π°ΠΌ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ Π±Π΅ΡΠΏΠ»Π°ΡΠ½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π½Π° 2010 Π³ΠΎΠ΄""
863:"ΠΠΎΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΈΠ΅ ΠΡΠ°Π²ΠΈΡΠ΅Π»ΡΡΡΠ²Π° Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ ΠΎΡ 21 ΠΎΠΊΡΡΠ±ΡΡ 2011 Π³. β 856. "Π ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠ΅ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΡΡ
Π³Π°ΡΠ°Π½ΡΠΈΠΉ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ Π³ΡΠ°ΠΆΠ΄Π°Π½Π°ΠΌ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ Π±Π΅ΡΠΏΠ»Π°ΡΠ½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π½Π° 2012 Π³ΠΎΠ΄""
876:
517:
Projections show that by the year 2033, the population of individuals 65 and older will increase by 45.1%, creating a demand for primary care physicians that is greater than the supply.
897:
734:
1365:
1465:
785:
153:, and every time they require an initial consultation about a new health problem. Collaboration among providers is a desirable characteristic of primary care.
593:
274:
The 2018 policy address proposed the establishment of the first district health centre and promoted the establishment of district centre in other districts.
549:
According to a FAIR Health analysis, 29 percent of patients who received medical care in the US between 2016 and 2022 did not see a primary care doctor.
1330:
Dill MJ, Pankow S, Erikson C, Shipman S (June 2013). "Survey shows consumers open to a greater role for physician assistants and nurse practitioners".
701:
384:
357:
POZ clinics are independent companies (except SPZOZ), however, the services they provide are free for insured persons when POZ has a contract with the
751:
599:
879:[The Russian Ministry of Health has prepared a Memo for citizens on the guarantees of free medical care] (in Russian). www.rosminzdrav.ru
1136:
American
Academy of Family Physicians (AAFP). Advancing Primary Care". Council on Graduate Medical Education: Twentieth Report. December 2010.
1913:
984:
157:
729:
1295:
Bodenheimer TS, Smith MD (November 2013). "Primary care: proposed solutions to the physician shortage without training more physicians".
682:
97:
or other traditional medicine professional (as in parts of Asia). Depending on the nature of the health condition, patients may then be
1193:
495:
1062:
1093:
1459:
407:
Primary pre-medical health care is provided by paramedics, obstetricians and other medical workers with secondary medical education.
611:
664:
1553:
1453:
391:
Primary health care is provided to citizens on an outpatient basis and in an inpatient setting, in planned and emergency forms.
223:, rapidly increasing demand for primary care services is expected around the world, in both developed and developing countries.
145:
is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and
1008:
1838:
1779:
1493:
1218:
464:
177:
468:
1736:
1741:
1242:
Sommers BD, Bindman AB (April 2012). "New physicians, the
Affordable Care Act, and the changing practice of medicine".
1037:
57:, and coordinates other care the patient may need. Patients commonly receive primary care from professionals such as a
1391:"Interventions for involving older patients with multi-morbidity in decision-making during primary care consultations"
524:
model is intended to help coordinate care with the primary care provider at the center of the patient's healthcare.
1920:
487:
476:
354:
The Act of
October 27, 2017 on basic health care (Journal of Laws of 2020, item 172) has been in force since 2017.
19:
This article is about a sector of the health care system. For the approach to providing universal health care, see
1168:
1940:
1908:
125:
strategy. Primary care involves the widest scope of healthcare, including all ages of patients, patients of all
1649:
1146:
907:
472:
460:
1886:
1871:
1609:
708:
438:
and community hearing care providers. Services are generally provided free-at-the-point-contact through the
1861:
300:(secondary care), while the federal government's role is mostly limited to coordinating the affairs of the
1891:
642:
480:
1119:
1935:
1881:
1664:
1604:
1486:
637:
181:
118:
877:"ΠΠΈΠ½Π·Π΄ΡΠ°Π² Π ΠΎΡΡΠΈΠΈ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΈΠ» ΠΠ°ΠΌΡΡΠΊΡ Π΄Π»Ρ Π³ΡΠ°ΠΆΠ΄Π°Π½ ΠΎ Π³Π°ΡΠ°Π½ΡΠΈΡΡ
Π±Π΅ΡΠΏΠ»Π°ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΊΠ°Π·Π°Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ"
338:
independent public health care institution (SPZOZ) - a state unit or subordinate to local government
141:. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas.
1930:
1794:
1533:
562:
There is currently limited evidence to form a robust conclusion that involving older patients with
220:
1829:
439:
301:
1094:"New Study Identifies Large Gaps in Lifetime Earnings of Specialist and Primary-care Physicians"
142:
1866:
930:
Greenfield G, Foley K, Majeed A (September 2016). "Rethinking primary care's gatekeeper role".
617:
534:
58:
49:. Typically this provider acts as the first contact and principal point of continuing care for
1978:
1855:
1756:
287:
254:, access to primary and other healthcare services is guaranteed for all citizens through the
245:
226:
Funding for primary care varies a great deal between different countries: general taxation,
121:
attributes the provision of essential primary care as an integral component of an inclusive
1957:
1925:
1849:
1543:
1528:
1479:
1070:
506:
431:
370:
358:
62:
46:
1097:
8:
1833:
632:
605:
538:
146:
98:
70:
20:
102:
1819:
1594:
1558:
1415:
1390:
965:
827:
627:
542:
502:
227:
122:
106:
78:
74:
26:
1389:
Butterworth JE, Hays R, McDonagh ST, Richards SH, Bower P, Campbell J (October 2019).
1766:
1751:
1746:
1653:
1523:
1518:
1441:
1420:
1347:
1312:
1259:
969:
957:
903:
255:
216:
169:
54:
831:
1843:
1784:
1690:
1513:
1444:
from
Institute of Medicine IOM β Primary Care: America's Health in a New Era (1996)
1410:
1406:
1402:
1339:
1304:
1251:
947:
939:
819:
622:
421:
376:
185:
150:
90:
82:
1705:
1700:
1659:
1625:
862:
845:
794:
738:
584:
313:
205:
201:
197:
66:
1789:
1774:
1645:
563:
427:
193:
1343:
1308:
1972:
1563:
1548:
1538:
823:
456:
435:
134:
126:
700:
Thomas-MacLean R, Tarlier D, Ackroyd-Stolarz S, Fortin M, Stewart M (2008).
455:
As of 2012, there were about six primary care professional societies in the
1876:
1809:
1804:
1685:
1640:
1424:
1351:
1316:
1263:
961:
952:
521:
412:
organizations that provide specialized, including high-tech, medical care.
161:
138:
1468:
Aboriginal Medical Services Alliance Northern Territory (AMSANT) Australia
1255:
699:
1502:
209:
344:
group medical practice - a group of private medical or nursing practices
1720:
1680:
1147:"The Number of Practicing Primary Care Physicians in the United States"
86:
42:
1290:
1288:
943:
1715:
1599:
753:
International Classification of Primary Care, Second edition (ICPC-2)
219:, with increasing numbers of older adults at greater risk of chronic
189:
1635:
1589:
1579:
1285:
297:
278:
transitional units offering the public with primary care services.
94:
50:
1009:"Health Insurance Coverage and the Affordable Care Act, 2010β2016"
527:
320:) is a basic, common element of the health care system in Poland.
304:
and university teaching hospitals (tertiary care).general medical
1799:
1695:
1584:
767:
341:
individual medical practice - private medical or nursing practice
293:
1447:
702:"No cookie-cutter response: conceptualizing primary health care"
430:, patients can access primary care services through their local
1630:
1388:
1194:"Breaking Down the Basics of the Patient-Centered Medical Home"
251:
173:
165:
130:
1471:
1015:. U.S. Department of Health & Human Services. 2 March 2016
501:
Primary healthcare results in better health outcomes, reduced
133:, and patients with all manner of acute and chronic physical,
1056:
1054:
985:"Strengthening Primary Care With A New Professional Congress"
129:
and geographic origins, patients seeking to maintain optimal
1450:
Definitions from American Academy of Family Physicians AAFP
1169:"Primary Care Physician Shortage - South Pointe Healthcare"
787:
Primary Care Needs New Innovations to Meet Growing Demands.
1051:
347:
group / individual practice of community and family nurses
30:
Primary care may be provided in community health centres.
1329:
812:
InnovAiT: Education and Inspiration for General Practice
1219:"Primary care 'medical home' model catching on, slowly"
1063:"Wage gap between specialists, primary-care physicians"
810:
Burch P (19 December 2018). "Funding in primary care".
335:
non-public healthcare facility (NZOZ) - private company
1126:. The Henry J. Kaiser Family Foundation. 25 June 2019.
533:
provides funding and mandates to increase the role of
16:
Day-to-day health care given by a health care provider
929:
594:
Anatomical Therapeutic Chemical Classification System
445:
clinical and non-clinical benefits outweigh the costs
574:
81:. In some localities, such a professional may be a
350:group / individual practice of community midwives.
1038:"AAMC Physician Workforce Policy Recommendations"
1970:
1294:
1191:
600:Classification of Pharmaco-Therapeutic Referrals
385:territorial compulsory health insurance programs
383:) in the Russian Federation is free (as part of
528:Strategies to address the primary care shortage
1281:. Upper Saddle River: West Publishing Company.
1241:
1149:. U.S. Department of Health and Human Services
494:On March 23, 2010, President Obama signed the
1487:
505:, and lower spending, including on avoidable
158:International Classification of Primary Care
1395:The Cochrane Database of Systematic Reviews
1032:
1030:
557:
267:preventive care for some chronic diseases.
1494:
1480:
1279:Health law; Cases, materials, and problems
1216:
1120:"Total Number of Medical School Graduates"
496:Patient Protection and Affordable Care Act
1414:
951:
780:
778:
769:Ageing and life course: Our ageing world.
552:
331:In organizational terms, POZ can act as:
234:
1045:Association of American Medical Colleges
1027:
857:
855:
612:International Classification of Diseases
204:and child health care services, such as
200:. Primary care also includes many basic
25:
982:
1971:
1462:Department of Health United Kingdom UK
1276:
1091:
1060:
775:
1839:Artificial intelligence in healthcare
1475:
1456:from American Medical Association AMA
983:Klepper B, et al. (2012-10-02).
899:Royal Commission on the NHS Chapter 7
852:
809:
693:
465:American Academy of Family Physicians
838:
469:Society of General Internal Medicine
137:and social health issues, including
434:, community pharmacy, optometrist,
13:
1914:reform debate in the United States
381:ΠΠ΅ΡΠ²ΠΈΡΠ½Π°Ρ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΠ°Π½ΠΈΡΠ°ΡΠ½Π°Ρ ΠΏΠΎΠΌΠΎΡΡ
14:
1990:
1941:(Category Health care by country)
1435:
415:
1953:
1952:
577:
488:New England Healthcare Institute
477:American Osteopathic Association
450:
318:Podstawowa Opieka Zdrowotna, POZ
1501:
1382:
1358:
1323:
1270:
1235:
1210:
1192:HealthITSecurity (2016-06-03).
1185:
1161:
1139:
1130:
1112:
1085:
1001:
976:
923:
890:
869:
683:"WHO/Europe β Main terminology"
404:primary specialized health care
398:primary pre-medical health care
93:(as in parts of Africa), or an
41:Primary care is the day-to-day
1650:Academic health science centre
1407:10.1002/14651858.cd013124.pub2
1217:Wooldridge S (24 April 2019).
1092:Finney K (18 September 2012).
803:
772:Geneva. Accessed 24 June 2011.
760:
757:Geneva. Accessed 24 June 2011.
744:
722:
675:
657:
596:(ATC classification for drugs)
473:American Academy of Pediatrics
461:American College of Physicians
394:Types of primary health care:
1:
1887:Health information management
1872:health information technology
1610:Health information management
709:University of Western Ontario
650:
564:multiple long-term conditions
112:
1862:Translational bioinformatics
1466:What is primary health care?
1460:Defining primary health care
1366:"A Window into Primary Care"
1061:Finney K (25 October 2010).
261:
7:
1892:Consumer health informatics
766:World Health Organization.
750:World Health Organization.
728:World Health Organization.
643:Primary Health Organisation
570:
481:American Geriatrics Society
10:
1995:
1454:Definition of Primary Care
419:
368:
285:
281:
243:
18:
1948:
1902:
1882:Public health informatics
1818:
1795:Electronic health records
1765:
1729:
1673:
1665:Supervised injection site
1618:
1605:Allied health professions
1572:
1509:
1371:. FAIR Health. 2023-03-15
1344:10.1377/hlthaff.2012.1150
1309:10.1377/hlthaff.2013.0234
1173:southpointehealthcare.com
638:Primary care service area
380:
364:
307:
239:
221:non-communicable diseases
139:multiple chronic diseases
119:World Health Organization
824:10.1177/1755738018805186
558:Involving older patients
1830:Medical image computing
1780:Artificial intelligence
535:mid-level practitioners
440:National Health Service
302:Federal Medical Centres
1867:Translational medicine
741:Accessed 24 June 2011.
618:Medical classification
553:Shared-decision making
317:
235:Primary care by region
59:primary care physician
31:
1856:Computational biology
1757:Universal precautions
1442:Defining Primary Care
1256:10.1001/jama.2012.523
486:A 2009 report by the
375:Primary health care (
369:Further information:
312:Basic Primary care, (
288:Healthcare in Nigeria
246:Health care in Canada
215:In context of global
29:
1850:Behavior informatics
1124:statehealthfacts.org
989:The Health Care Blog
731:Definition of Terms.
539:physician assistants
507:emergency department
401:primary medical care
371:Healthcare in Russia
359:National Health Fund
63:general practitioner
47:health care provider
1834:imaging informatics
1742:Cultural competence
902:. HMSO. July 1979.
798:HealthLeaders Media
633:Primary care ethics
606:Direct primary care
543:nurse practitioners
491:the United States.
198:thyroid dysfunction
71:physician assistant
21:Primary health care
1820:Health informatics
1595:Healthcare science
1277:Furrow BR (2013).
1073:on 30 January 2014
793:2011-07-11 at the
737:2011-03-03 at the
628:Physician shortage
503:health disparities
228:national insurance
123:primary healthcare
79:nurse practitioner
75:physical therapist
32:
1966:
1965:
1730:Skills / training
1654:Teaching hospital
1198:HealthITAnalytics
944:10.1136/bmj.i4803
256:Canada Health Act
217:population ageing
55:healthcare system
1986:
1956:
1955:
1844:Neuroinformatics
1785:Connected health
1496:
1489:
1482:
1473:
1472:
1429:
1428:
1418:
1386:
1380:
1379:
1377:
1376:
1370:
1362:
1356:
1355:
1327:
1321:
1320:
1292:
1283:
1282:
1274:
1268:
1267:
1239:
1233:
1232:
1230:
1229:
1214:
1208:
1207:
1205:
1204:
1189:
1183:
1182:
1180:
1179:
1165:
1159:
1158:
1156:
1154:
1143:
1137:
1134:
1128:
1127:
1116:
1110:
1109:
1107:
1105:
1096:. Archived from
1089:
1083:
1082:
1080:
1078:
1069:. Archived from
1058:
1049:
1048:
1042:
1034:
1025:
1024:
1022:
1020:
1005:
999:
998:
996:
995:
980:
974:
973:
955:
927:
921:
920:
918:
916:
894:
888:
887:
885:
884:
873:
867:
866:
859:
850:
849:
842:
836:
835:
807:
801:
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