This report reflects on the findings from an internal control assessment of health service delivery units for primary health care, as well as a subsequent options analysis. Together, they show significant opportunities for improved systemic efficiency, as low-value, frequent transactions (that...

Background Evidence on the cost effectiveness of deprescribing in multimorbidity is limited. Objective To investigate the cost effectiveness of a general practitioner (GP) delivered, individualised medication review to reduce polypharmacy and potentially inappropriate prescribing in older...

The report is based on the WBG's technical assistance which aimed to 1) provide a baseline of current PHC performance, understand the strengths and weaknesses of the PHC system, and where to target initiatives for improvement; 2) identify and understand variation in PHC performance, especially...

Offering health coverage to informal workers and their families is an ongoing and major challenge in most Sub-Saharan countries. As anchoring insurance to employment contracts is not possible and the demand for insurance is too low to deploy voluntarily sustainable schemes, alternative...

We study how the threat of entry affects service quantity and quality of general practitioners (GPs). We leverage Germany's needs-based primary care planning system, in which the likelihood of new GPs reduces by 20 percentage points when primary care coverage exceeds a cut-off. We compile novel...

We study how the threat of entry affects service quantity and quality of general practitioners (GPs). We leverage Germany's needs-based primary care planning system, in which the likelihood of new GPs reduces by 20 percentage points when primary care coverage exceeds a cut-off. We compile novel...

Cet article décrit un programme mis en place en Côte d'Ivoire pour évaluer etrenforcer les compétences des prestataires de soins de santé primaires à l'aide devignettes cliniques. L'initiative a permis de former les superviseurs de district dans 113districts sanitaires sur la manière de...

While physicians are crucial to patient outcomes, what determines physician behavior and decision making remains to be understood. In this paper, we study how physicians' family characteristics influence physicians' behavior and patient health outcomes. Using administrative data from Denmark and...

Purpose: This study addresses the qualitative research phase of a mixed methods study conducted to investigate patient acceptance of an app-based telemedicine service for primary care aimed at South African public health care sector patients. Design/methodology/approach: Qualitative data were...

Objective The integration of the health insurance fund pool may threaten the sustainability of the fund by increasing its expenditures through the exacerbation of the moral hazard of participations. The purpose of this paper is to assess and predict the impact of the single pool reform of...

This report presents the findings of the Vital Signs Profile (VSP) assessment conducted by the World Bank and the Primary Health Care Performance Initiative (PHCPI) in collaboration with Fiji's Ministry of Health and Medical Services (MHMS). The VSP provides an opportunity to assess the state of...

The assessment of Kiribati's primary health care (PHC) system, carried out by the World Bank in collaboration with the Government of Kiribati under the Primary Health Care Performance Initiative (PHCPI), marks a unique opportunity to identify the system's strengths and gaps and to catalyze...

This report presents the findings of the primary health care (PHC) system in the Republic of the Marshall Islands (RMI), an assessment that the World Bank conducted in consultation with the Ministry of Health and Human Services (MHHS) of the government of RMI. The assessment provides an...

Non-communicable diseases (NCDs) are increasingly placing significant health and economic burdens on low- and middle-income countries (LMICs). Primary care serves as the initial point of contact for individuals seeking medical assistance and plays a pivotal role in promoting health, preventing...

We study the effects of general practitioners’ (GPs’) resignations on their patients’ healthcare utilization, diagnoses, and mortality in an event-study setting. Using claims data from a large German statutory health insurance, we find that after physicians leave, their former patients...

This study evaluates the accessibility of primary care for children in Czechia in light of the declining numbers of general practitioners and the rising numbers of children without a practitioner. We show that children largely receive primary care outside their district of administrative...

The share of female physicians has risen in OECD countries in recent decades, but we know little about the effects of physician gender. We exploit quasi-random assignment of primary care providers (PCPs) to patients and estimate the causal effect of female PCPs on health care provision. Using...

Prolonged hospital stays, or hospital stays that are longer than medically necessary, are a major concern for patients, payers, and providers. We conceptualize and empirically estimate the prevalence and cost of prolonged stays among elderly hospital patients (65 years and older) in Brazil and...

We quantify the impact of federal subsidies for graduate medical education on primary care physician (PCP) supply by examining the impact of Section 5503 of the Affordable Care Act, which increased the number of residents that teaching hospitals in rural and high-need areas could receive...

Unlike most European countries, a majority of the population in Ireland pay out of pocket for a range of primary-care services, including general practitioner (GP) care. In 2017, the Committee on the Future of Healthcare published its final report (the Sláintecare Report; Houses of the...

Unlike most European countries, a majority of the population in Ireland pay out of pocket for a range of primary-care services, including general practitioner (GP) care. In 2017, the Committee on the Future of Healthcare published its final report (the Sláintecare Report; Houses of the...

Market frictions, such as imperfect information or hassle costs, may reduce the efficiency of consumer choice in healthcare settings. Thus, reducing such frictions may presumably lead to higher quality care. We use data from two randomized policy interventions in a Swedish region, which improved...

The World Health Organization (WHO) should act as the directing and coordinating authority in global health but it has been steadily marginalized over time by design, through criticism as an inefficient organization, the reduction of assessed contributions and consequent impoverishment, and the...

This document presents the core protocol for ECDC studies of CVE and IVE against symptomatic laboratoryconfirmed influenza or SARS-CoV-2 infection, respectively, at primary care level. This core protocol presents the main elements for a multicentre (multi-country) study of IVE/CVE at primary...

We live in a rapidly aging world, in which people who are 60 years and older outnumber children under the age of five. This book reveals large and growing gaps in care for older adults in countries at all income levels and shows how to leverage reforms for improving health outcomes for older...

Implementation science is a multidisciplinary field that focuses on studying and promoting effective strategies for translating evidence-based interventions (EBIs) into routine practice to improve outcomes in real-world settings. It has been increasingly used to document and assess...

This report presents the findings of the primary health care (PHC) system assessment in the Republic of Moldova undertaken by the World Bank in collaboration with the Moldovan government and under the leadership of the Ministry of Health (MoH). It highlights existing strengths, identifies areas...

The results of the assessment point to four policy recommendations to address challenges related to governance, availability of medicines and supplies, comprehensiveness of services, and ability to deliver adolescent sexual and reproductive health (ASRH) services and promote universal and...

While the incidence of COVID-19 in Belize has subsided, the lasting health and economic impacts caused by the pandemic have demonstrated the need to build a resilient health system. The most recent figures from the Statistical institute of Belize confirm that there have been over 60,000 cases...