In April 2008, 24 distinguished experts from Europe and the US came together at the Rockefeller Foundation Bellagio Study and Conference Center. Under the conference title "Improving primary care in Europe and the US: Towards patient-centered, proactive and coordinated systems of care" practitioners, researchers and policy advisers together discussed and designed the Bellagio Model on Population-oriented Primary Care.
The Bellagio Model on population-oriented primary care is a comprehensive reference framework for accessible, continuous, comprehensive, population-oriented primary care in the 21st century that ensures coordination with other care when needed. Its ten key features are defined and composed in a way that they all form part of the model and are mutually reinforcing.
Levers for patient support and care coordination
The Bellagio Model is particularly apt to cope with the needs of the chronically ill. Put in more general terms, our model is well suited to support and activate all patients that need orientation and help with complex health care needs and growing fragility. Consistently applied the Bellagio Model provides levers to overcome the divide between doctors, professions, care cultures, institutions, and governance environments.
Need for health system improvement and change
Named after the location situated on Northern Italy's Lake Como, the Bellagio Model is the result of an intense, five-day work retreat that took place at the renowned Rockerfeller Foundation's Conference Center in April 2008. 24 primary care experts from policy, management and practice with different professional backgrounds agreed that health systems must become more pro-active, helping populations and individuals to stay healthy and prevent the development of (additional) chronic conditions. Primary care as a hub linking health care and social services, as first contact care, accessible by all, guaranteeing a sustained and trustworthy partnership between providers and patients, comprehensive, coordinated care for a predetermined population, activated by patient choice plays an essential role in improving health care systems altogether.
System changes endorsed by politics in some countries do in fact support these developments: Participants looked back at more than ten years of experience in implementing new approaches in primary care from Europe and the U.S. that take into account the special needs of individuals with chronic conditions, and assessed the various strategies for improvement.
Expertise and experience from nine countries
The experts examined different approaches and strategies from nine countries (United Kingdom, Denmark, Spain (Catalonia), USA, Germany, France, The Netherlands, Poland, Estonia) based on country case studies and technical papers that had been prepared by participants prior to the conference.
One of the models participants looked at more in depth was the Chronic Care Model (CCM), an acknowledged, practice-proof, conceptual framework that has served as a key reference to construct the Bellagio Model. Widely used in U.S. healthcare organizations and adopted in several European countries the CCM describes changes to the organization and delivery of care at the practice level that help to improve outcomes among patients with chronic conditions.
Participants also assessed technical and managerial findings from research evidence and practice - issues that are critical for primary care and health care improvement overall.
Top row: Nick Goodwin, Chuck Kilo, Jennifer Dixon, Josep Argimon, Michel Wensing, Chris Ham, Bert Vrijhoef, Jochen Gensichen, John Tooker, Ed Wagner, Derek Feeley, Marianne Samuelson, Zbigniew Krol
Front row: Anne Frolich, Norbert Donner-Banzhoff, Yann Bourgueil, Barbara Starfield, Sophia Schlette, Tino Martí, Melanie Lisac, Sophia Chang, Thomas Heil, Frede Olesen, Ain Aaviksoo