Sharing Responsibility – Joint Planning: the Role of Primary Care Physicians in Regional Health Care
DOI: 10.3238/zfa.2015.0499-0505german translation / full article
Background: With its Declaration of Alma Ata (1978) the World Health Organization (WHO) gave clear guidance for a fair and fully accessible health care system based on Primary Health Care (PHC). However, this approach was hardly acknowledged in Germany. The increasing demographic aging of the population as well as the problems of health care coverage in rural districts of Germany make Regional Health Care (RHC) as a modern approach of PHC a meaningful concept of planning and responsibility.
Methods: This article derives the role of primary care physicians in RHC. Firstly, it analyzed the health care situation in rural regions of Germany. Afterwards the concept of RHC is developed so that finally RHC and primary care physicians can be related to each other.
Results: Increasing aging of the population, the reduction of provider density and the decreasing population density call for stronger coordination of medical service provision. The Primary Health Care concept of WHO called for a strong role of the government in this coordination process, but RHC sees a stronger responsibility of the service providers. They are called for sharing responsibility and joint planning in their catchment areas.
Conclusions: Primary care physicians are not only a major contributor to the health of the population from a medical perspective, but they are also important coordinators in the complex network of service provision. Their coordination activities should be strengthened and remuneration should be accordingly. However, this requires also sufficient training in strategic management, leadership and teambuilding.