Open Access Highly Accessed Study protocol

QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care

Willemijn LA Schäfer1*, Wienke GW Boerma1, Dionne S Kringos1, Jan De Maeseneer2, Stefan Greß3, Stephanie Heinemann3, Danica Rotar-Pavlic4, Chiara Seghieri5, Igor Švab4, Michael J Van den Berg67, Milena Vainieri5, Gert P Westert8, Sara Willems2 and Peter P Groenewegen19

Author Affiliations

1 NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands

2 Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium

3 Hochschule Fulda - University of Applied Sciences, Fulda, Germany

4 ULMF- University of Ljubljana, Ljubljana, Slovenia

5 Laboratorio MeS, Istituto di Management, Scuola Superiore Sant'Anna, Italy

6 RIVM- National Institute for Public Health and the environment, Bilthoven, The Netherlands

7 Tranzo, Tilburg University, Tilburg, The Netherlands

8 Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

9 Department of Sociology and Department of Human Geography, Utrecht University, Utrecht, The Netherlands

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BMC Family Practice 2011, 12:115  doi:10.1186/1471-2296-12-115

Published: 20 October 2011



The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary care systems have on the performance of health care systems. QUALICOPC is funded by the European Commission under the "Seventh Framework Programme". In this article the background and design of the QUALICOPC study is described.


QUALICOPC started in 2010 and will run until 2013. Data will be collected in 31 European countries (27 EU countries, Iceland, Norway, Switzerland and Turkey) and in Australia, Israel and New Zealand. This study uses a three level approach of data collection: the system, practice and patient. Surveys will be held among general practitioners (GPs) and their patients, providing evidence at the process and outcome level of primary care. These surveys aim to gain insight in the professional behaviour of GPs and the expectations and actions of their patients. An important aspect of this study is that each patient's questionnaire can be linked to their own GP's questionnaire. To gather data at the structure or national level, the study will use existing data sources such as the System of Health Accounts and the Primary Health Care Activity Monitor Europe (PHAMEU) database. Analyses of the data will be performed using multilevel models.


By its design, in which different data sources are combined for comprehensive analyses, QUALICOPC will advance the state of the art in primary care research and contribute to the discussion on the merit of strengthening primary care systems and to evidence based health policy development.