results local level of primary health care system in iran had mechanical structure, but in contextual dimensions the results showed different types. there was a significant relationship between structural and contextual dimensions (r = 0.642, p value < 0.001). goals and culture dimensions had strongest effects on structural dimensions. background in recent years, family physician plan was estab...

In their 2016 article, Saltman and Duran provide a thoughtful examination of the governance challenges involved in different care delivery models adopted in primary care and hospitals in two European countries. This commentary examines the limited potential of structural changes to achieve real reform and considers that, unless governance arrangements actually succeed in penetrating organizatio...

Primary healthcare in Portugal is undergoing a major reform, of which family health units (FHU) are one of the more visible results. This study aimed to evaluate the FHU implementation process from 2006 onwards. Methods from a previous study of primary healthcare implementation in Brazil were used. Dimensions studied included comprehensiveness of care, organization of care, and the political-in...

This proposal for health system reform, known as Equicare, was developed for the 1994 gubernatorial primary race in Penn-sylvania. But incomplete access, inadequacies in public programs , inefficiencies in care, and other problems experienced in Pennsylvania are not unique to that state. While Pennsylvania data and financing plans support the case for this type of reform, the proposal could be ...

Family practice became the 20th medical specialty in 1969, identified by its leaders as a harbinger of health care reform, as well as practice excellence, and with expectations of continuing government support of its purpose and role. Since that time, the cultural and political environments have changed significantly in some ways, and not changed in others as initially expected, thus challengin...

The widening income gap between specialists and primary care physicians (PCPs) has spurred many physician associations to reform the current Resource-Based Relative Value Scale fee schedule and sustainable growth rate expenditure target system. Hoping to better represent primary care, the American Association of Family Physicians formed a task force in 2011 to suggest supplements to the Relativ...

The aim of this paper is to present the effects of the reform of primary care by privatization and direct contracting between general practitioners/family physicians and the Croatian Institute for Health Insurance, as well as to propose possible improvements. Using the data of the Croatian Institute of Public Health, we analyzed the coverage of population and accessibility of service, managemen...