Primary care addresses the most common health problems in the community, integrates care where there are multiple health problems and addresses the context in which illness occurs.9 The WHO identifies primary care as the linchpin of health equity and achieving health outcomes for all, supported by robust theoretical and empirical evidence, with strong national primary care systems associated with improved equity and health indicators.8,11,12
In both developed and developing nations, evidence exists for the link between a strong primary health care system and equity.13 Generally, primary health care is perceived as more equitable than other forms of health care, in part because it requires fewer resources.13 Numerous studies have identified the link between strong primary health care and improved health outcomes related to mortality, morbidity, patient experiences and self-reported health status.13,14 These outcomes are commonly associated with lower expenditure on individual and system costs.
9 Primary Health Care Reform in Australia: Report to Support Australia's First National Primary Health Care Strategy. Canberra: Australian Government; Department of Health and Ageing;2009.
10 The World Health Report 2008: Primary care now more than ever. Geneva: WHO 2008.
11 Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within OECD countries, 1970–1998. Health Serv Res. 2003;38:819–853. Health Services Research. 2003;38:819 - 853.
12 Starfield B. Is Strong Primary Care Good for Health Outcomes? The Future of Primary Care: Papers for a Symposium held on 13th September 1995. 1996:18 - 29.
13 Starfield B, Shi L, Macinko J. Contribution of Primary Care to Health Systems and Health. Milbank Q. 2005;83(3):457-502.
14 Starfield B. Primary Care and Health: A Cross National Comparison. Journal of American Medical Association. 1991;266:2268-2271.