Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012

. 2016 Feb 3;34(1):97–110. doi: 10.3109/02813432.2015.1132887

	First contact care	Treatment of diseases	Technical Procedures	Prevention
Urgency of reform
In-/decrease in life expectancy 1990–1995:
Model 1
Life expectancy: Stand. B (p-value)	−0.366 (0.055)^*	0.255 (0.191)	−0.234 (0.231)	−0.066 (0.737)
R²	0.134	0.065	0.055	0.004
Model 1 + breadth service profiles 1993
Life expectancy: Stand. B (p-value)	−0.218 (0.135)	0.145 (0.431)	−0.174 (0.393)	−0.082 (0.649)
Breadth service profiles 1993: Stand. B (p-value)	−0.645 (0.000)^*	−0.424 (0.028)^*	−0.201 (0.323)	−0.451 (0.018)^*
R²	0.528	0.233	0.092	0.208
Model 1 + GDP
Life expectancy: Stand. B (p-value)	−0.139 (0.560)	0.159 (0.538)	−0.323 (0.217)	−0.024 (0.927)
Increase in GDP: Stand. B (p-value)	0.347 (0.154)	−0.146 (0.569)	−0.138 (0.595)	0.064 (0.890)
R²	0.203	0.077	0.066	0.007
In-/Decrease health care expenditure (% GDP):
Model 1
Health care expenditure: Stand. B (p-value)	0.115 (0.562)	0.432 (0.022)^*	−0.014 (0.945)	0.275 (0.156)
R²	0.013	0.187	0.000	0.076
Model 1 + breadth service profiles 1993


Health care expenditure: Stand. B (p-value)	0.315 (0.028)^*	0.339 (0.057)^*	0.060 (0.768)	0.206 (0.256)
Breadth service profiles 1993: Stand. B (p-value)	−0.776 (0.000)^*	−0.378 (0.035)^*	−0.269 (0.192)	−0.413 (0.028)^*
R²	0.575	0.321	0.067	0.242
Model 1 + GDP
Health care expenditure: Stand. B (p-value)	0.364 (0.060)^*	0.397 (0.056)^*	0.021 (0.924)	0.376 (0.081)
Increase in GDP: Stand. B (p-value)	0.591 (0.004)^*	−0.083 (0.679)	0.083 (0.710)	0.239 (0.259)
R²	0.301	0.192	0.006	0.123
% population > 65 (n = 28):
Model 1
Increase in % population > 65: Stand. B (p-value)	0.072 (0.714)	0.017 (0.931)	−0.008 (0.969)	0.078 (0.695)
R²	0.005	0.000	0.000	0.006
Model 1 + breadth service profiles 1993
Increase in % population > 65: Stand. B (p-value)	−0.131 (0.383)	−0.021 (0.908)	−0.121 (0.573)	0.229 (0.219)
Breadth service profiles 1993: Stand. B (p-value)	−0.731 (0.000)^*	−0.463 (0.015)^*	−0.304 (0.164)	−0.515 (0.009)^*
R²	0.499	0.213	0.076	0.249
Model 1 + GDP
Increase in % population > 65: Stand. B (p-value)	−0.091 (0.639)	0.118 (0.569)	−0.020 (0.925)	0.057 (0.792)
Increase in GDP: Stand. B (p-value)	0.470 (0.021)^*	−0.291 (0.168)	0.081 (0.706)	0.061 (0.778)
R²	0.135	0.075	0.006	0.009
Family orientation (n = 25):
Model 1
Family orientation: Stand. B (p-value)	0.314 (0.126)	−0.201 (0.335)	0.077 (0.714)	−0.152 (0.469)
R²	0.099	0.040	0.006	0.023
Model 1 + breadth service profiles 1993	−0.347 (0.095)^*	−0.451 (0.019)^*	−0.270 (0.413)	−0.052 (0.788)
Family orientation: Stand. B (p-value)

Breadth service profiles 1993: Stand. B (p-value)	−0.946 (0.000)^*	−0.653 (0.001)^*	−0.447 (0.181)	−0.470 (0.022)^*
R²	0.556	0.404	0.085	0.234
Model 1 + GDP
Family orientation: Stand. B (p-value)	0.137 (0.535)	−0.079 (0.738)	0.071 (0.774)	−0.232 (0.340)
Increase in GDP: Stand. B (p-value)	0.365 (0.109)	−0.252 (0.291)	0.013 (0.958)	0.166 (0.493)
R²	0.200	0.089	0.006	0.044
Politics
Left-wing government (n = 27):
Model 1
Left-wing government: Stand. B (p-value)	0.015 (0.941)	0.224 (0.269)	−0.079 (0.661)	0.023 (0.908)
R²	0.000	0.050	0.006	0.001
Model 1 + breadth service profiles 1993
Left-wing government: Stand. B (p-value)	0.138 (0.386)	0.254 (0.208)	−0.050 (0.803)	0.178 (0.346)
Breadth service profiles 1993	−0.667 (0.000)^*	−0.208 (0.300)	−0.254 (0.212)	−0.521 (0.010)^*
R²	0.431	0.092	0.070	0.249
Model 1 + GDP
Left-wing government: Stand. B (p-value)	0.075 (0.682)	0.191 (0.333)	−0.071 (0.733)	0.034 (0.870)
Increase in GDP: Stand. B (p-value)	0.481 (0.014)^*	−0.258 (0.195)	0.065 (0.755)	0.084 (0.684)
R²	0.228	0.116	0.010	0.008
Means
Government effectiveness (n = 28):
Model 1
Government effectiveness: Stand. B (p-value)	−0.560 (0.002)^*	−0.110 (0.577)	−0.099 (0.615)	0.081 (0.683)
R²	0.314	0.012	0.010	0.007
Model 1 + breadth service profiles 1993
Government effectiveness: Stand. B (p-value)	−0.069 (0.760)	0.227 (0.293)	0.176 (0.533)	0.075 (0.679)
Breadth service profiles 1993	−0.642 (0.008)^*	−0.591 (0.010)^*	−0.380 (0.184)	−0.447 (0.019)^*
R²	0.485	0.248	0.079	0.206
Model 1 + GDP
Government effectiveness: Stand. B (p-value)	−0.470 (0.034)^*	−0.434 (0.073)^*	−0.089 (0.735)	0.213 (0.404)
Increase in GDP: Stand. B (p-value)	0.145 (0.494)	−0.521 (0.034)^*	−0.020 (0.938)	0.213 (0.404)
R²	0.327	0.178	0.010	0.034
Centralization health care system (n = 28):
Model 1
Centralization health care system: Stand. B (p-value)	0.284 (0.143)	−0.091 (0.644)	0.280 (0.149)	0.084 (0.669)
R²	0.081	0.008	0.078	0.007
Model 1 + breadth service profiles 1993
Centralization health care system: Stand. B (p-value)	0.211 (0.140)	−0.011 (0.953)	0.249 (0.201)	0.125 (0.489)
Breadth service profiles 1993	−0.672 (0.000)^*	−0.460 (0.017)^*	−0.217 (0.261)	−0.459 (0.016)^*
R²	0.527	0.213	0.125	0.216
Model 1 + GDP
Centralization health care system: Stand. B (p-value)	0.121 (0.543)	0.017 (0.936)	0.302 (0.165)	0.062 (0.781)
Increase in GDP: Stand. B (p-value)	0.387 (0.060)^*	−0.258 (0.239)	−0.053 (0.803)	0.054 (0.807)
R²	0.204	0.063	0.081	0.010
Professional status of GPs:
Model 1
Professional status: Stand. B (p-value)	0.211 (0.281)	0.188 (0.337)	−0.009 (0.963)	0.062 (0.752)
R²	0.045	0.035	0.000	0.004
Model 1 + breadth service profiles 1993
Professional status: Stand. B (p-value)	0.259 (0.066)^*	0.251 (0.156)	−0.018 (0.927)	0.031 (0.865)
Breadth service profiles 1993	−0.712 (0.000)^*	−0.493 (0.008)^*	−0.253 (0.202)	−0.446 (0.020)^*
R²	0.550	0.117	0.064	0.202
Model 1 + GDP
Professional status: Stand. B (p-value)	0.142 (0.437)	0.237 (0.226)	−0.003 (0.987)	0.050 (0.805)
Increase in GDP: Stand. B (p-value)	0.414 (0.030)^*	−0.290 (0.141)	0.074 (0.716)	0.072 (0.725)
R²	0.212	0.117	0.006	0.009

*Significant at p < 0.1.