Priorities for health services research in primary care.

BACKGROUND: All European health systems face several common challenges related to increases in lifestyle and chronic diseases, a decreasing future workforce, inequalities in health and the consequences of societal changes. Primary care, which has the potential to help meet these challenges, would benefit from the contribution of health services research (HSR) on a wide range of topics. As funding for such research is limited, priorities need to be defined. AIM: With the European Union (EU) funded project Health Services Research into European Policy and Practice (HSREPP) we identified several HSR priority areas for health care in general across Europe. This article focuses on our findings as they apply to primary care.
METHODS: General findings of the HSREPP project were based on bibliometric analyses of past research and ongoing EU-funded projects, an online expert survey and conference discussion. We checked these general findings by presenting the preliminary results at the third biannual conference of the European Forum for Primary Care in 2010. During this conference a debate was held on whether the identified research topics were also applicable to primary care.
RESULTS: Several research areas were identified. At the level of the healthcare system these areas included evaluation of primary care reforms, the influence of funding on cooperation between primary care providers plus workforce management and migration. At the organisational level the relationship between primary and secondary care, the internal organisation of primary care settings, patient involvement and community oriented care and aspects of professional-manager relations need to be studied. Finally, the role of primary care in increasing equity in access and health outcomes was found to be an important topic for future research.
CONCLUSIONS: Given funding constraints, it is imperative that research priorities are identified to ensure that resources are devoted to the most pressing and important issues facing primary care. Priority areas for future research are amongst others the evaluation of primary care reforms in Europe, and the relations between primary and secondary care.