BACKGROUND Primary health care and its strengthening through performance measurement is essential for sustainably working towards universal health coverage. Existing performance frameworks and indicators to measure primary health care capture system functions like governance, financing and resourcing but to a lesser extent the function of services delivery and its heterogeneous nature. Moreover, most frameworks have weak links with routine information systems and national health priorities, especially in the context of high- and middle-income countries. This paper presents the development of a tool that responds to this context with the aim to create primary health care performance intelligence for the 53 countries of the WHO European Region. METHODS The work builds-off of an existing systematic review on primary care and draws on priorities of current European health policies and available (inter)national information systems. Its development included: (i) reviewing and classifying features of primary care; (ii) constructing a set of tracer conditions; and (iii) mapping existing indicators in the framework resulting from (i). The analysis was validated through a series of reviews: in-person meetings with country-nominated focal points and primary care experts; at-distance expert reviews; and, preliminary testing with country informants. RESULTS The resulting framework applies a performance continuum in the classical approach of structures-processes-outcomes spanning 6 domains - primary care structures, model of primary care, care contact, primary care outputs, health system outcomes, and health outcomes - that are further classified by 26 subdomains and 63 features of primary care. A care continuum was developed using a set of 12 tracer conditions. A total of 139 indicators were mapped to the classification, each with an identified data source to safeguard measurability. Individual indicator passports and a glossary of terms were developed to support the standardization of the findings. CONCLUSION The resulting framework and suite of indicators, coined the Primary Health Care Impact, Performance and Capacity Tool (PHC-IMPACT), has the potential to be applied in Europe, closing the gap on existing data collection, analysis and use of performance intelligence for decision-making towards primary health care strengthening.

中文翻译：

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创建绩效情报以加强欧洲的初级卫生保健。

背景技术初级卫生保健及其通过绩效评估的加强对于可持续地实现全民健康覆盖至关重要。现有的绩效框架和指标可用于衡量基本医疗保健捕获系统的功能，例如治理，融资和资源配置，但程度较小的是服务提供的功能及其异构性质。此外，大多数框架与常规信息系统和国家卫生优先事项之间的联系薄弱，尤其是在高收入和中等收入国家的情况下。本文介绍了一种针对这种情况的工具的开发，旨在为世卫组织欧洲区域的53个国家创建主要的卫生保健绩效情报。方法该工作建立在对初级保健的现有系统评价的基础上，并借鉴了当前欧洲卫生政策和可用的（国际）国家信息系统的优先级。它的发展包括：（i）审查和分类初级保健的特征；（ii）建立一套追踪条件；（iii）绘制由（i）得出的框架中的现有指标。通过一系列审查对分析进行了验证：与国家提名的联络人和初级保健专家的面对面会议；远程专家评论；并与国家线人进行初步测试。结果最终的框架采用了跨越6个领域的结构，过程，结果的经典方法中的绩效连续体-初级保健结构，初级保健模型，护理联系，初级保健产出，卫生系统成果，和健康结果-根据26个子域和63个初级保健特征进一步分类。使用一组12种示踪剂条件开发了一个护理连续体。总共将139个指标映射到该分类，每个指标都有一个确定的数据源以维护可度量性。制定了单独的指标护照和术语表以支持调查结果的标准化。结论由此产生的框架和一套指标，被称为“初级卫生保健影响，绩效和能力工具”（PHC-IMPACT），有可能在欧洲应用，从而缩小了现有数据收集，分析和使用绩效智能的差距。加强初级卫生保健的决策。使用一组12种示踪剂条件开发了一个护理连续体。总共将139个指标映射到该分类，每个指标都有一个确定的数据源以维护可度量性。制定了单独的指标护照和术语表以支持调查结果的标准化。结论由此产生的框架和一套指标，被称为“初级卫生保健影响，绩效和能力工具”（PHC-IMPACT），有可能在欧洲应用，从而缩小了现有数据收集，分析和使用绩效智能的差距。加强初级卫生保健的决策。使用一组12种示踪剂条件开发了一个护理连续体。总共将139个指标映射到该分类，每个指标都有一个确定的数据源以维护可度量性。制定了单独的指标护照和术语表以支持调查结果的标准化。结论由此产生的框架和一套指标，被称为“初级卫生保健影响，绩效和能力工具”（PHC-IMPACT），有可能在欧洲应用，从而缩小了现有数据收集，分析和使用绩效智能的差距。加强初级卫生保健的决策。制定了单独的指标护照和术语表以支持调查结果的标准化。结论由此产生的框架和一套指标，被称为“初级卫生保健影响，绩效和能力工具”（PHC-IMPACT），有可能在欧洲应用，从而缩小了现有数据收集，分析和使用绩效智能的差距。加强初级卫生保健的决策。制定了单独的指标护照和术语表以支持调查结果的标准化。结论由此产生的框架和一套指标，被称为“初级卫生保健影响，绩效和能力工具”（PHC-IMPACT），有可能在欧洲应用，从而缩小了现有数据收集，分析和使用绩效智能的差距。加强初级卫生保健的决策。