Primary Health Care Quality Indicators for a More Sustainable Health Care System in Lithuania

Recent international research indicates that health care systems with stronger focus on primary care have better outcomes for less money than those with a strong focus on hospital care (Macinko, 2003; Starfield, 1998; 2005). This means that strong primary care increases sustainability of all health care systems. Nevertheless, when comparing different countries, the term primary care has different meanings and there are various forms of primary health care systems and providers. New challenges are ageing population, burden of chronically ill patients, new expensive technologies and increased overall costs of health care. Politicians and payers now more than ever are interested in efficiency and sustainability of health care systems in order to give best value for money. The objective of the article is to summarize the existing primary health care performance indicators and list potential PHC quality indicators that would support a more sustainable health care system in Lithuania. This article is based on the “Improvement of public health by promoting equitably distributed, high quality primary health care systems” (ImPrim) project and the activities related to elaboration of an operational evidence system based and widely recognised as quality indicators for PHC performance. This study was prepared using relevant literature, websites, but also several e-mail contacts, phone calls, workshops, seminars and practices. In summary, Lithuania health care quality needs to be assessed from the point of view of structure, process and outcomes. Such the stakeholders as patients, health care providers, professionals, financiers and also decision-makers (politicians) should be involved in the development and the selection of quality indicators. Good primary health care should not be limited to the diagnosis and the treatment of the presented problems but it has to demonstrate a comprehensive approach, patient centeredness, holistic approach, coordination of care and teamwork.