Country | Primary care payment | Does primary care control access to secondary care? | Patient required or encouraged to register with a primary care physician or practice? | Predominant form of primary care provision |
---|---|---|---|---|
Austria | Fee-for-service | No need and no incentive to obtain referral | No incentive and no requirement to register | Solo practice |
Belgium | Capitation/fee-for-service | Financial incentives to obtain a referral, but direct access is possible | No requirement to register, but there are financial incentives to do so | Solo practice |
Bulgaria15,16 | Capitation/fee-for-service/other | Primary care physician referral is required | No incentive and no requirement to register | Solo practice |
Cyprus17 | Fee-for-service | No need and no incentive to obtain referral | No incentive and no requirement to register | Group practice |
Czech Republic | Capitation/fee-for-service/pay for performance | No need and no incentive to obtain referral | No incentive and no requirement to register | Solo practice |
Denmark | Capitation/fee-for-service | Financial incentives to obtain a referral, but direct access is possible | No requirement to register, but there are financial incentives to do so | Solo practice |
England | Capitation/fee-for-service/pay for performance | Primary care physician referral is the usual way to access secondary care, but direct access is possible | No incentive and no requirement to register | Group practice |
Estonia | Capitation/fee-for-service/pay for performance/other | Primary care physician referral is required | Registration required | Solo practice |
Finland | Global budget | Primary care physician referral is required | Registration required | Group practice |
Former Yugoslav Republic of Macedonia18 | Capitation/other | Financial incentives to obtain a referral, but direct access is possible | Registration required | Solo practice |
Germany | Fee-for-service | No need and no incentive to obtain referral | No requirement to register, but there are financial incentives to do so | Solo practice |
Greece | Global budget | No need and no incentive to obtain referral | No incentive and no requirement to register | Group practice |
Hungary15,16 | Capitation/pay for performance/global budget | Primary care physician referral is required | No incentive and no requirement to register | Solo practice |
Iceland | Fee-for-service/global budget | No need and no incentive to obtain referral | No incentive and no requirement to register | Group practice |
Ireland17 | Capitation/fee-for-service | Primary care physician referral is required | No incentive and no requirement to register | Group practice |
Italy | Capitation | Primary care physician referral is required | Registration required | Group practice |
Latvia | Capitation/fee-for-service/pay for performance/fixed payments | Financial incentives to obtain a referral, but direct access is possible | Registration required | Group practice |
Lithuania | Capitation/fee-for-service/pay for performance/global budget | Primary care physician referral is required | Registration required | Group practice |
Luxembourg | Capitation/fee-for-service | No need and no incentive to obtain referral | No incentive and no requirement to register | Solo practice |
Malta15,16 | Fee-for-service | Financial incentives to obtain a referral, but direct access is possible | No incentive and no requirement to register | Solo practice |
Netherlands | Capitation/fee-for-service/pay for performance | Primary care physician referral is required | No incentive and no requirement to register | Group practice |
Norway | Capitation/fee-for-service | Primary care physician referral is required | Registration required | Group practice |
Poland | Capitation/fee-for-service | Primary care physician referral is required | No incentive and no requirement to register | Group practice |
Portugal | Capitation/pay for performance/global budget | Primary care physician referral is required | Registration required | Group practice |
Romania15,16 | Capitation/fee-for-service | Financial incentives to obtain a referral, but direct access is possible | Registration required | Solo practice |
Slovakia15,16 | Capitation/fee-for-service/other | Financial incentives to obtain a referral, but direct access is possible | Registration required | Solo practice |
Slovenia | Capitation/fee-for-service | Primary care physician referral is required | Registration required | Group practice |
Spain | Capitation/fee-for-service/global budget | Primary care physician referral is required | Registration required | Group practice |
Sweden | Capitation/fee-for-service | Primary care physician referral is required | No incentive and no requirement to register | Group practice |
Switzerland | Capitation/fee-for-service | Financial incentives to obtain a referral, but direct access is possible | No requirement to register, but there are financial incentives to do so | Solo practice |
Turkey | Global budget | No need and no incentive to obtain referral | Registration required | Group practice |
Source: Organisation for Economic Co-operation and Development Health Systems Characteristics Survey19 except where noted otherwise.