http://doi.org/10.24945/MVF.04.25.1866-0533.2731

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After more than 30 years of development, physician networks represent a promising approach to strengthening outpatient care in Germany. In light of growing supply bottlenecks, demographic change, and a growing need for interprofessional collaboration, they are increasingly becoming the focus of health policy. The resulting network structure is extremely heterogeneous, both in terms of structure, maturity, and actual effectiveness. This article analyzes the current state of development of physician networks in Germany, identifies key success factors, and explores their future potential. Using selected best-practice examples, it demonstrates the conditions under which physician networks can not only contribute to improving care but also function as economically viable business models. This provides concrete recommendations for action to further develop physician networks and establish them as a strategic management instrument in the healthcare system.

In health systems where primary care has a coordinating and gatekeeping function, patients are typically required to consult a designated primary care physician before accessing specialist services. The introduction of a primary care system with a coordinating and gatekeeping role to promote targeted care and fast appointment allocation for Germany was recently agreed politically for the 2025-2029 legislative period. The implementation specifics are still being discussed. In this article, we analyze components of nine European healthcare systems and Israel, with a focus on the coordinating and gatekeeping function of primary care, and derive implications for the German context.

comparative analysis, coordination, Primary care system, Primary care

comparative country analysis, coordination, gatekeeping, primary care

Literature (tables) Anderson, Michael; Pitchforth, Emma; Edwards, Nigel; Alderwick, Hugh; McGuire, Alistair; Mossialos, Elias (2022): United Kingdom: health system review. In: Health Systems in Transition 24 (1), pp. 1–194. Bernal Delgado, Enrique; Angulo Pueyo, esters; Ridao-López, Manuel; Urbanos-Garrido, Rosa M.; Oliva Moreno, Juan; García-Abiétar, Daniel; Hernández-Quevedo, Cristina (2024): Spain: health system review 2024. In: Health Systems in Transition 26 (3), pp. 1–187. Birk, Hans Okkels; Vrangbæk, Karsten; Rudkjøbing, Andreas; Krasnik, Allan; Eriksen, Astrid; Richardson, Erica; Jervelund, Signe Smith (2024): Denmark: Health System Review. In: Health Systems in Transition 26 (1), pp. 1–186. Brownwood, I.; Lafortune, G. (2024): Advanced practice nursing in primary care in OECD countries: Recent developments and persistent implementation challenges. Ed. OECD Publishing. Paris (OECD Health Working Papers, 165). Available online at https://doi.org/10.1787/8e10af16-en, last accessed on April 8, 2025. Comunidad de madrid (2025): Tarjeta Sanitaria. Available online at https://www.comunidad.madrid/servicios/salud/tarjeta-sanitaria, last accessed on April 4, 2025. Deutsches Ärzteblatt (2024): What Germany could learn from the Finnish health system. Available online at https://www.aerzteblatt.de/news/was-deutschland-vom-finnischen-gesundheitssystem-lernen-koennte-44f6148a-03bf-43b7-b994-2613210cd1bb, last accessed on April 4, 2025. Durand-Zaleski, Isabelle (2020): International Health Care System Profiles: France. Ed. by The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/france, last accessed on February 21, 2025. Federal Office of Public Health (2024): Health insurance: Restricted choice of providers. Available online at https://www.bag.admin.ch/bag/en/home/versicherungen/krankenversicherung/krankenversicherung-versicherte-mit-wohnsitz-in-der-schweiz/besondere-versicherungsformen/modelle-eingeschraenkte-wahl.html, last updated on June 27, 2024, last checked on April 14, 2025. Giulio de Belvis, Antonio; Meregaglia, Michela; Morsella, Alisha; Adduci, Andrea; Perilli, Alessio; Cascini, Fidelia et al. (2022): Italy: Health System Review. In: Health Systems in Transition 24 (4), pp. 1–236. Helveticare (2023): Alternative insurance models: Your needs are more important than premium discounts. Available online at https://www.helveticcare.ch/alternative-versicherungsmodelle-ihre-beduerfnisse-sind-wichtiger-als-praemienrabatte, last updated on October 9, 2023, last checked on May 7, 2025. Jefferies, Danielle (2024): Primary care services in a nutshell. Available online at https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/primary-care-nutshell, last updated on April 29, 2024, last checked on May 16, 2025. KPT - The Health Insurance with the Plus (2024): Family Doctor Model: How does it work and what are the advantages and disadvantages? Available online at https://www.kpt.ch/de/magazin/was-ist-das-hausarztmodell, last checked on April 4, 2025. Kroneman, Madelon; Jong, Judith de; Polin, Kate; Webb, Erin (2024): The Netherlands: health system summary 2024. Ed. of European Observatory on Health Systems and Policies. Available online at https://eurohealthobservatory.who.int/publications/i/the-netherlands-health-system-summary-2024, last accessed on 08.04.2025. L'assurance maladie (2025): Consultations en métropole: vos remboursements. Available online at https://www.ameli.fr/paris/assure/remboursements/rembourse/consultations-telemedecine/metropole, last updated on 08.04.2025, last accessed on 14.04.2025. Leumit Health Services (2023): Your Health. Available online at https://www.leumit.co.il › eng, last checked on March 11, 2025. Marchildon, Gregory P.; Brammli-Greenberg, Shuli; Dayan, Mark; Belvis, Antonio Giulio de; Gandre, Coralie; Isaksson, David et al. (2021): Achieving higher performing primary care through patient registration: A review of twelve high-income countries. In: Health Policy 125 (12), pp. 1507–1516. DOI: 10.1016/j.healthpol.2021.09.001. McDermott, Imelda; Spooner, Sharon; Goff, Mhorag; Gibson, Jon; Dalgarno, Elizabeth; Francetic, Igor et al. (2022 May): Scale, scope and impact of skill mix change in primary care in England: a mixed-methods study. National Institute for Health and Care Research. Southampton (UK) (Health and Social Care Delivery Research). Medical Systems (2023): Israel's largest healthcare provider to use Sectra's digital pathology solution for improved cancer diagnostics. Available online at https://medical.sectra.com/news-press-releases/news-item/C4370CC351B503BB/, last accessed on March 11, 2025. Ministry of Health and Care Services (2024): The Basic Structure of the Norwegian health service. Available online at https://www.regjeringen.no/en/topics/health-and-care/innsikt/the-basic-structure-of-the-norwegian-health-service/id227440/, last updated on October 15, 2024, last accessed on April 8, 2025. NHS England (2024): NHS self-referral for tests and appointments for hundreds of thousands of patients. Available online at https://www.england.nhs.uk/2024/04/nhs-self-referral-for-tests-and-appointments-for-hundreds-of-thousands-of-patients/, last updated on 09.04.2024, last checked on 12.02.2025. NHS England (2025): Building a team with the skills to boost primary care in West Leeds Primary Care Network. Available online at https://www.england.nhs.uk/gp/case-studies/building-a-team/, last checked on 07.04.2025. Or, Zeynep; Gandré, Coralie; Seppänen, Anna-Veera; Hernández-Quevedo, Cristina; Webb, Erin; Michel, Morgane; Chevreul, Karine (2023): France: health system review. In: Health Systems in Transition 25 (3), pp. 1–276. Patient Federation Netherlands (2025): Niet inschrijven bij huisarts. Available online at https://kennisbank.patientenfederatie.nl/app/answers/detail/a_id/1431/~/niet-inschrijven-bij-huisarts, last updated on January 14, 2025, last checked on May 12, 2025. Press Portal Switzerland - Media Releases (2018): Over 60 percent are insured under the family doctor model / Media release on the 20th anniversary of hawadoc AG. Available online at https://www.presseportal-schweiz.ch/pressemeldungen/ueber-60-prozent-sind-im-hausarztmodell-versichert-medienmitteilung-zum-20-jahre, last updated on July 16, 2018, last checked on May 7, 2025. Saunes, Ingrid Sperre; Karanikolos, Marina; Sagan, Anna (2020): Norway: Health System Review. In: Health Systems in Transition 22 (1), pp. 1–163. Schmitt-Sausen, Nora (2010): Finnish Health System: Well-Organized, Efficient, Good? In: Dtsch Arztebl International 9 (9), -399-. Available online at https://www.aerzteblatt.de/archiv/finnisches-gesundheitssystem-durchorganisiert-effizient-gut-4db822ef-170e-402c-84cd-eb77d15f2f10, last accessed on April 14, 2024. Swiss Forum for Integrated Care (2023): Alternative insurance models (AVM) with a contractual arrangement between health insurers and medical service providers are the most common insurance product – Impressive continuous growth. Available online at https://fmc.ch/wp-content/uploads/2023/10/AVM-Versicherte-2022_fmc-Impuls-01.2023.pdf, last updated on January 2023, last accessed on May 7, 2025. Shahaed, Heba; Glazier, Richard H.; Anderson, Michael; Barbazza, Erica; Bos, Veronique LLC; Saunes, Ingrid S. et al. (2023): Primary care for all: lessons for Canada from peer countries with high primary care attachment. In: CMAJ 195 (47), E1628-E1636. sperre Saunes, Ingrid (2020): International Health Care System Profiles: Norway. Ed. The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/norway, last checked on February 21, 2025. Tikkanen, Roosa; Osborn, Robin; Mossialos, Elias; Djordjevic, Ana; Wharton George A. (2020): International Health Care System Profiles: Netherlands. Ed. The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/netherlands, last accessed on February 21, 2025. Vrangbæk, Karsten (2020): International Health Care System Profiles: Denmark. Ed. by The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/denmark, last accessed on February 21, 2025. Waitzberg, Ruth; Rosen, Bruce (2020): International Health Care System Profiles: Israel. Ed. by The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/israel, last accessed on February 21, 2025. References (Text) Anderson, Michael; Pitchforth, Emma; Edwards, Nigel; Alderwick, Hugh; McGuire, Alistair; Mossialos, Elias (2022): United Kingdom: health system review. In: Health Systems in Transition 24 (1), pp. 1–194. AOK Baden-Württemberg: Contract for family doctor-centered care in Baden-Württemberg dated May 8, 2008, as amended on November 1, 2024, pursuant to Section 73b of the Social Code Book V (SGB V). 2024. Available online at https://www.aok.de/gp/fileadmin/user_upload/Arzt_Praxis/Aerzte_Psychotherapeuten/Vertraege_Vereinbarungen/Hausarztzentrierte_Versorgung/Baden-Wuerttemberg/bw_gesamtvertrag_hzv_ohne_anlage_17.pdf, last accessed on March 18, 2025. Bernal-Delgado, Enrique; Angulo-Pueyo, Ester; Ridao-López, Manuel; Urbanos-Garrido, Rosa M.; Oliva Moreno, Juan; García-Abiétar, Daniel; Hernández-Quevedo, Cristina (2024): Spain: health system review 2024. In: Health Systems in Transition 26 (3), pp. 1–187. Birk, Hans Okkels; Vrangbæk, Karsten; Rudkjøbing, Andreas; Krasnik, Allan; Eriksen, Astrid; Richardson, Erica; Jervelund, Signe Smith (2024): Denmark: Health System Review. In: Health Systems in Transition 26 (1), pp. 1–186. Bodenheimer, Thomas; Ghorob, Amireh; Willard Grace, Rachel; Grumbach, Kevin (2014): The 10 Building Blocks of High-Performing Primary Care. In: The Annals of Family Medicine 12 (2), pp. 166–171. DOI: 10.1370/afm.1616. Brownwood, I.; Lafortune, G. (2024): Advanced practice nursing in primary care in OECD countries: Recent developments and persisting implementation challenges. Ed. OECD Publishing. Paris (OECD Health Working Papers, 165). Available online at https://doi.org/10.1787/8e10af16-en, last accessed on April 8, 2025. Federal Office of Justice: Social Code (SGB), Book Five (V) - Statutory Health Insurance - (Article 1 of the Act of December 20, 1988, Federal Law Gazette I, p. 2477) Section 73b Family doctor-centered care. Available online at https://www.gesetze-im-internet.de/sgb_5/__73b.html, last accessed on March 18, 2025. CDU (2025): Coalition Agreement 2025: Responsible Foreign Policy. Available online at https://www.cdu.de/aktuelles/koalitionsvertrag-2025-verantwortungsvolle-aussenpolitik/, last updated on April 17, 2025, last accessed on April 22, 2025. Comunidad de Madrid (2025): Tarjeta Sanitaria. Available online at https://www.comunidad.madrid/servicios/salud/tarjeta-sanitaria, last accessed on April 4, 2025. DigiFinland: Omaolo. How are you feeling? Available online at https://www.omaolo.fi/, last accessed on April 15, 2025. eHealth Suisse: Competence and Coordination Center of the Confederation and Cantons (2025): EPD: Electronic Patient Record. Available online at https://www.patientendossier.ch/fachpersonen, last updated on April 9, 2025. Fascicolo Sanitario Elettronico (2025): The Electronic Health Record (EHR). Available online at https://www.fascicolosanitario.gov.it/en/electronic-health-record-ehr.html, last accessed on April 9, 2025. Federal Office of Public Health (2024): Health insurance: Restricted choice of providers. Available online at https://www.bag.admin.ch/bag/en/home/versicherungen/krankenversicherung/krankenversicherung-versicherte-mit-wohnsitz-in-der-schweiz/besondere-versicherungsformen/modelle-eingeschraenkte-wahl.html, last updated on June 27, 2024, last checked on April 14, 2025. Garrido, Marcial Velasco; Zentner, Annette; Busse, Reinhard (2011): The effects of gatekeeping: A systematic review of the literature. In: Scandinavian Journal of Primary Health Care 29 (1), pp. 28–38. DOI: 10.3109/02813432.2010.537015. Gerlach, Ferdinand M.; Szecsenyi, Joachim (2011): Family doctor-centered care. Content and quality are crucial. In: Deutsches Ärzteblatt 108, pp. 996–998. Giulio de Belvis, Antonio; Meregaglia, Michela; Morsella, Alisha; Adduci, Andrea; Perilli, Alessio; Cascini, Fidelia et al. (2022): Italy: Health System Review. In: Health Systems in Transition 24 (4), pp. 1–236. Glonti, Ketevan; Struckmann, Verena; Alconada, Alvaro; Pettigrew, Luisa M.; Hernandez Santiago, Virginia; Minue, Sergio et al. (2019): Exploring the training and scope of practice of GPs in England, Germany and Spain. In: Gaceta sanitaria 33 (2), pp. 148–155. DOI: 10.1016/j.gaceta.2017.10.011. Government of the Netherlands (2025): More Q&As about health insurance in the Netherlands. Available online at https://www.government.nl/topics/health-insurance/question-and-answer/more-qas-about-health-insurance-in-the-netherlands, last accessed on April 2, 2025. Griese, Lennert; Schaeffer, Doris; Berens, Eva-Maria (2023): Navigational health literacy among people with chronic illness. In: Chronic Illness 19 (1), pp. 172–183. Gurtner, Sebastian; Wettstein, Miriam (2019): Interprofessional collaboration in healthcare – incentives and barriers to professional practice. In: Bern University of Applied Sciences, Department of Business, Institute of Business Development: Published online. Hägglund, Maria; Kharko, Anna; Bärkås, Annika; Blease, Charlotte; Cajander, Åsa; DesRoches, Catherine et al. (2024): A Nordic perspective on patient online record access and the European health data space. In: Journal of Medical Internet Research 26, e49084. General Practitioners Association (2025a): General practitioner contracts. Available online at https://www.haev.de/themen/hausarztvertraege, last accessed on April 22, 2025. General Practitioners Association (2025b): HZV breaks the 10 million mark – “If the new government wants a primary care doctor model, then it must rely on the HZV.” Available online at https://www.haev.de/presse-medien/pressemitteilungen/nachrichten-detailansicht/hzv-durchbricht-10-millionen-marke-wenn-die-neue-regierung-ein-primaerarztmodell-will-dann-muss-sie-auf-die-hzv-setzen, last updated on May 9, 2025, last accessed on June 4, 2025. Healthcare Denmark: General Practitioners. Available online at https://healthcaredenmark.dk/national-strongholds/population-health/general-practitioners/, last accessed on April 14, 2025. Helsana: BeneFit PLUS Flexmed. Available online at https://www.helsana.ch/de/private/versicherungen/grundversicherung/benefit-plus-flexmed.html, last accessed on April 15, 2025. Helsana: Expert second opinion for more security. Available online at https://www.helsana.ch/de/private/wissen/spital/experten-zweitmeinung.html#:~:text=ersteAnlaufstelleimmerIhreHausrztin, last accessed on April 9, 2025. IGES Institute (2020): International comparison of outpatient remuneration. Report on an international comparison of outpatient medical remuneration from a health economics perspective. Available online at https://www.bundesgesundheitsministerium.de/service/publikationen/details/internationaler-vergleich-der-ambulanten-aerztlichen-verguetung-aus-gesundheitsoekonomischer-perspektive.html, last accessed on February 26, 2025. Keskimäki, Ilmo; Tynkkynen, Liina-Kaisa; Reissell, Eeva; Koivusalo, Meri; Syrjä, Vesa; Vuorenkoski, Lauri et al. (2019): Finland: Health System Review. In: Health Systems in Transition 21 (2), pp. 1–166. Klauber, Jürgen; Wasem, Jürgen; Beivers, Andreas; Mostert, Carina (2021): Hospital Report 2021: Supply Chains – The Patient at the Center: Springer Nature. Klora, Mike; Zeidler, Jan; May, Melanie; Raabe, Nils; von der Schulenburg, J-Matthias Graf (2017): Evaluation of family doctor-centered health care in Germany based on AOK Rheinland/Hamburg claims data. In: Journal of Evidence, Continuing Education and Quality in Health Care 120, pp. 21–30. DOI: 10.1016/j.zefq.2016.12.005. KPT: The health insurance company with the Plus (2025): Checking symptoms online: practical and time-saving. Available online at https://www.kpt.ch/de/magazin/symptome-online-checken, last updated on March 26, 2025, last checked on April 15, 2025. Kroneman, Madelon; Boerma, Wienke; van den Berg, Michael; Groenewegen, Peter; Jong, Judith de; van Ginneken, Ewout; World Health Organization (2016): Netherlands: health system review. In: Health Systems in Transition 18 (2), pp. 1–240. Laux, Gunter; Szecsenyi, J.; Mergenthal, K.; Beyer, M.; Gerlach, F.; Stock, C. et al. (2015): Family doctor-centered care in Baden-Württemberg. In: Federal Health Gazette Health Research Health Protection 58 (4-5), pp. 398–407. Lenz, Katharina (2022): Finland: eHealth and health centers. Ed. by KBV klartext. Available online at https://www.kbv-klartext.de/gesundheit-anderswo/finnland-ehealth-und-gesundheitszentren.html, last accessed on March 27, 2025. Liu, Ville; Koskela, Tuomas H.; Kaila, Minna (2023): User-Initiated Symptom Assessment With an Electronic Symptom Checker: Protocol for a Mixed Methods Validation Study. In: JMIR research protocols 12, e41423. DOI: 10.2196/41423. Marchildon, Gregory P.; Brammli-Greenberg, Shuli; Dayan, Mark; Belvis, Antonio Giulio de; Gandre, Coralie; Isaksson, David et al. (2021): Achieving higher performing primary care through patient registration: A review of twelve high-income countries. In: Health Policy 125 (12), pp. 1507–1516. DOI: 10.1016/j.healthpol.2021.09.001. Ministry of Health Israel (2024): Second Medical Opinion. Available online at https://me.health.gov.il/en/older-adult/services-rights/diagnoses/second-opinion/, last updated on January 2nd, 2024, last checked on April 9th, 2025. Mon espace santé: Un service de l'assurance maladie ministère de la santé et de l'accès aux soins, santé famille retraite service (2025): Le service public pour gérer sa santé: Vous avez la main sur votre santé. Available online at https://www.monespacesante.fr/, last checked on April 9, 2025. National Health Service (2022): How NHS 111 online works. Available online at https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-use-111/how-nhs-111-online-works/?_id=111. Website last updated 14 November 2022, last checked 15 April 2025. NHS Confederation (2011): Any Qualified Provider. Available online at https://www.nhsconfed.org/system/files/2021-05/Any-qualified-provider.pdf, last updated July 2011, last checked 19 May 2025. NHS England (2022): When to use NHS 111 online or call 111. Available online at https://www.nhs.uk/nhs-services/urgent-and-emergency-care-services/when-to-use-111/, last updated 14 November 2022. NHS England (2023a): How it works: Find out how the NHS Pathways service works. Available online at https://digital.nhs.uk/services/nhs-pathways/how-it-works, last updated 22 June 2023, last checked 15 April 2025. NHS England (2023b): Referrals for specialist care. Available online at https://www.nhs.uk/nhs-services/hospitals/referrals-for-specialist-care/, last updated on 12 April 2023, last checked on 16 May 2025. Or, Zeynep; Gandré, Coralie; Seppänen, Anna-Veera; Hernández-Quevedo, Cristina; Webb, Erin; Michel, Morgane; Chevreul, Karine (2023): France: health system review. In: Health Systems in Transition 25 (3), pp. 1–276. Orchard, Carole A.; Curran, Vernon; Kabene, Stefane (2005): Creating a culture for interdisciplinary collaborative professional practice. In: Medical Education Online 10 (1), p. 4387. Pietro, Carlo de; Camenzind, Paul; Sturny, Isabelle; Crivelli, Luca; Edwards-Garavoglia, Suzanne; Spranger, Anne et al. (2015): Switzerland: Health System Review. In: Health Systems in Transition 17 (4), pp. 1–288. Popert, Uwe W.; Egidi, Günther; Eras, Johanna; Kühlein, Thomas; Baum, Erika (2018): Why we need a primary care system. In: Journal of General Medicine 94 (6), pp. 250–254. DOI: 10.3238/zfa.2018.0250-0254. Region of Southern Denmark, Praksisinformation (2025): 96-day primary care system. Available online at https://www.sundhed.dk/sundhedsfaglig/information-til-praksis/syddanmark/almen-praksis/regionalt/nyheder/regionale-nyheder/nyt-fra-regionen/nyt-2025-januar-sygehusenes-96-timers-behandlingsansvar/, last updated on January 14, 2025, last accessed on April 22, 2025. Robert Bosch Stiftung (2015): Health Centers for Germany: How a New Beginning in Primary Care Can Succeed. Available online at https://www.bosch-stiftung.de/sites/default/files/publications/pdf/2021-05/Studie_Primaerversorgung_Gesundheitszentren-fuer-Deutschland.pdf, last accessed on March 25, 2025. Rosen, Bruce; Waitzberg, Ruth; Merkur, Sherry (2015): Israel: health system review. In: Health Systems in Transition 17 (6), pp. 1–212. Rotar, Alexandru M.; Van Den Berg, Michael J; Schäfer, Willemijn; Kringos, Dionne S.; Klazinga, Niek S. (2018): Shared decision making between patient and GP about referrals from primary care: Does gatekeeping make a difference? In: PloS one 13 (6), e0198729. DOI: 10.1371/journal.pone.0198729. German Advisory Council on Health and Care (2024): Health care professionals. Sustainable use of a scarce resource. Available online at https://www.svr-gesundheit.de/, last accessed on February 17, 2025. German Advisory Council on Health and Care (2023): Resilience in the health care system. Ways to cope with future crises. Report 2023. Available online at https://www.svr-gesundheit.de/fileadmin/Gutachten/Gutachten_2023/Gesamtgutachten_ePDF_Final.pdf, last accessed on February 18, 2025. Saultz, John W. (2003): Defining and measuring interpersonal continuity of care. In: The Annals of Family Medicine 1 (3), pp. 134–143. Saunes, Ingrid Sperre; Karanikolos, Marina; Sagan, Anna (2020): Norway: Health System Review. In: Health Systems in Transition 22 (1), pp. 1–163. SBK (2024): Learning from Finland. Available online at https://www.sbk.org/presse/von-finnland-lernen/, last accessed on April 4, 2025. Schaeffer, Doris; Hämel, Kerstin; Ewers, Michael; Breakfast, Parliamentary (2015): Care models for rural and structurally weak regions: Beltz Juventa. Shahaed, Heba; Glazier, Richard H.; Anderson, Michael; Barbazza, Erica; Bos, Véronique LLC; Saunes, Ingrid S. et al. (2023): Primary care for all: lessons for Canada from peer countries with high primary care attachment. In: CMAJ 195 (47), E1628-E1636. Sperre Saunes, Ingrid (2020): International Health Care System Profiles: Norway. Ed. by The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/norway, last accessed on February 21, 2025. Sripa, Poompong; Hayhoe, Benedict; Garg, Priya; Majeed, Azeem; Greenfield, Geva (2019): Impact of GP gatekeeping on quality of care, and health outcomes, use, and expenditure: a systematic review. In: British Journal of General Practice 69 (682), e294–e303. DOI: 10.3399/bjgp19X702209. Sturm, Heidrun; Julia, Weber; Tonaco Borges, Fabiano; Dickinson, Andrew; Sottas, Beat; Wennerholm, Carina et al. (2025): Patient's Perception of Primary Health Care Provision With Respect to Access, Continuity and Coordination—InCept: An International Qualitative Perspective. In: The International Journal of Health Planning and Management. Sturny, Isabelle (2020): International Health Care System Profiles: Switzerland. Ed. The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/switzerland, last accessed on February 21, 2025. Techniker Krankenkasse (2025): Is the TK family doctor program right for me? Available online at https://www.tk.de/techniker/versicherung/tk-leistungen/arzt-und-krankenhausbesuch/hausarztprogramm/tk-hausarztprogramm-teilnahmebedingungen-2076690, last accessed on March 18, 2025. The Wellbeing Services County of Ostrobothnia: Assess your symptoms online (Omaolo). Available online at https://en.osterbottensvalfard.fi/our-services/emergency-care-and-ae/omaolo/, last accessed on April 15, 2025. Thiel, Rainer; Deimel, Lucas; Schmidtmann, Daniel; Piesche, Klaus; Hüsing, Tobias; Rennoch, Jonas et al. (2018): #SmartHealthSystems. Ed. by Bertelsmann Stiftung. Available online at https://www.bertelsmann-stiftung.de/de/publikationen/publikation/did/smarthealthsystems, last accessed on April 8, 2025. Tikkanen, Roosa; Osborn, Robin; Mossialos, Elias; Djordjevic, Ana; Wharton George A. (2020): International Health Care System Profiles: Netherlands. Ed. by The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/netherlands, last accessed on February 21, 2025. van Lerberghe, Wim (2008): The world health report 2008: primary health care: now more than ever: World Health Organization. Vrangbæk, Karsten (2020): International Health Care System Profiles: Denmark. Published by The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/denmark, last accessed on February 21, 2025. Waitzberg, Ruth; Rosen, Bruce (2020): International Health Care System Profiles: Israel. Published by The Commonwealth Fund. Available online at https://www.commonwealthfund.org/international-health-policy-center/countries/israel, last accessed on February 21, 2025. World Health Organization: Integrated primary care for UHC. Available online at https://www.who.int/teams/integrated-health-services/clinical-services-and-systems/primary-care, last accessed on April 23, 2025. World Health Organization (2010): Framework for action on interprofessional education and collaborative practice. Available online at https://www.who.int/publications/i/item/framework-for-action-on-interprofessional-education-collaborative-practice, last accessed on 03.06.2025.

The authors declare that there are no conflicts of interest.

Our special thanks go to Andrea Donatini, Prof. Antonio de Belvis, Ingrid Sperre Saunes, Prof. Isabelle Durand-Zaleski, Isabelle Sturny, Prof. Karsten Vrangbæk, Lauri Vuorenkoski, Dr. Madelon Kroneman, Dr. Michael Anderson, Dr. Rosa María Urbanos Garrido, Ruth Thorlby, Dr. Ruth Waitzberg and Prof. Zeynep Or for their expert support in classifying country-specific features, for validating the timeliness of the information and for their helpful advice on the respective healthcare systems.