REVIEW – February 2005

Indicators of the evaluation of primary health care reform


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In 2003, a set of indicators, based on the criteria of allocative efficiency, technical efficiency and financial sustainability, was proposed for assessing the PHC reform (1). This system of indicators was used for the evaluation of the Estonian primary health care reform in 1998–2002 (2). The indicators of allocative efficiency encompass necessary provision of family doctors, access to PHC for all the population registered in the patient lists, and distribution between group and solo practices. All these indicators show the resources available to PHC to provide the needed amounts of services. Also, there is a dimension of equity considering the size of the patient list, which influences accessibility of services.

The indicators of technical efficiency charac-terize the use of PHC services, as well as the FD’s gatekeeper’s role in provision of health care. Also, supplying family doctors with necessary equipment gives them more possibility to achieve a better output per input. These indicators were chosen as the most relevant during the period of rapid changes in the provision of health care, as they can be measured using available data.

The indicators of financial sustainability show the financial situation on the macro and micro levels: on the national level through the distribution of resources between primary care and secondary care, and on the level of service provision through the structure of the budget of FD practices.