[Research and the recent evolution of primary health care].

Primary care in Spain has undergone a burgeoning phase in the 80's, followed by a decade of stagnation in the 90's, with little creativity, a routinisation of tasks, and the set up of service port-folios and program-contracts. On the other hand, the recent changes in the orientation of the research promoted by the health administration, in favor of basic research, at the expense of health services research and clinical epidemiology, are in contrast with the importance of primary care as a natural setting for the management of many causal agents and risk factors for health. Despite such limitations, the culture of research has become present in many primary care centres and pharmacies, and primary care research is increasingly present in scientific journals. Nevertheless, it is necessary, also for the case of primary care, to manage research, in differentiated and specific ways, favoring priorization, evaluation and responsibility through flexible organisational formulas and information systems. This should include contracting procedures allowing for at least part-time research, as well as professional career models acknowledging research and teaching activities. Scientific and professional associations in primary care face the challenge of maintaning research projects, of increasing their presence among professionals, of formulating opinions regarding the problems of their sector, as well as of reinforcing their organizational and communication capabilities.