For the fifth time, the Bertelsmann Stiftung has invited health policy actors to discuss innovative concepts in health policy and health system organization. This time, discussion revolved around how a well organized, patient-oriented primary care sector can help to improve coordination and efficiency of care.

Germany: Gatekeeper models on the rise

In Germany, health care reforms of recent years have strengthened the position of primary care. Gatekeeper models were introduced in 2000; since 2007 sickness funds have to offer these models to their insured. The number of participants is rising: In 2007 about 5.8 million patients had signed up for a gatekeeper model.

Netherlands: Strong primary care system

Professor Peter Groenewegen of Utrecht University presented the Dutch approach to primary care, which is more comprehensive than its German equivalent. To face the challenges of chronic diseases and multimorbidity, in the Netherlands family phyiscians are supported by new academically trained nursing professions. "Nurse practitioners", "physician assistants" und "mental health nurses" work together with physicians to achieve comprehensive, patient-oriented primary care.  Medical centers combine a range of primary care services, including pharmacy, dietrician services or psychological services under one roof. The change towards a strong primary care delivery system is supported by a new financing structure, treatment guidelines and quality management.