A Health Affairs Web First study released yesterday finds that five European countries have adopted aspects of patient-centered medical homes, a US model for comprehensive care. However, additional efforts are needed to fully implement this concept outside the United States.

The data for the study were gathered through a survey, questioning 6,428 patients who had one of eight common chronic illnesses. Also, 152 primary care providers across five European countries (Belgium, Denmark, Germany, the Netherlands, and England) were queried.

Marjan Faber of Radboud University in the Netherlands and coauthors report that each country offered high quality of care for its patients. Between 87 and 98 percent of patients in Germany, Belgium, the Netherlands, and Denmark had a single primary care physician. The rate was lower in England — 74 percent — where more primary care tasks are typically delegated to nurses. Although the survey demonstrated agreement in most areas between patients and physicians in evaluating their primary care experience, significant differences did emerge in the Belgian, Dutch, and English samples on frequency of illness self-management instructions.

“A strong focus in the European reforms on practice organization may have undermined the core values of a productive doctor-patient partnership,” conclude the authors. “The results highlight the extent to which patients value having a personal physician, even when structural aspects of their health care systems, such as teams and copayments, stand in the way.”

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