System Analysis of Ambulatory Care in Selected Countries

The Working Group 5 of the International Medical Informatics Associa tion (IMIA) is dedicated to information systems in primary care with special emphasis on computer systems in the doctor's office. Accord ingly, a conference was held in Hannover in 1980 where the first ap proaches were described and experiences in system analysis, system construction and evaluation were discussed (Rienhoff, O. and Abrams, M.E. (eds.): The Computer in the Doctor's Office, North-Holland, Amsterdam: 1980). Computer hardware and software development has been rapid over the last years. Thus the prerequisites for a successful support of the work of the physician in his office have improved. But system con struction still lags behind and the actual penetration of systems is lower than 2 % of the doctors' offices in most countries. This applies to industrialized countries. However, attempts are made everywhere to improve primary care by means of modern information technology. Information systems depend upon the real environment into which they are placed: administrative procedures govern priorities and procedures in doctor's office computers, possibilities to defray cost upon the various carriers or the patients have a great influence on the propagation of systems. Furthermore, various procedures of accounting or re-imbursement may lead to a facilitation or to a delay of the in troduction of systems. The 'art of medical practice' has reached a comparable standard within at least the industrialized countries.

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The Working Group 5 of the International Medical Informatics Associa­ tion (IMIA) is dedicated to information systems in primary care with special emphasis on computer systems in the doctor's office. Accord­ ingly, a conference was held in Hannover in 1980 where the first ap­ proaches were described and experiences in system analysis, system construction and evaluation were discussed (Rienhoff, O. and Abrams, M.E. (eds.): The Computer in the Doctor's Office, North-Holland, Amsterdam: 1980). Computer hardware and software development has been rapid over the last years. Thus the prerequisites for a successful support of the work of the physician in his office have improved. But system con­ struction still lags behind and the actual penetration of systems is lower than 2 % of the doctors' offices in most countries. This applies to industrialized countries. However, attempts are made everywhere to improve primary care by means of modern information technology. Information systems depend upon the real environment into which they are placed: administrative procedures govern priorities and procedures in doctor's office computers, possibilities to defray cost upon the various carriers or the patients have a great influence on the propagation of systems. Furthermore, various procedures of accounting or re-imbursement may lead to a facilitation or to a delay of the in­ troduction of systems. The 'art of medical practice' has reached a comparable standard within at least the industrialized countries.

Contenu
Information for Primary Health Care Who's Viewpoint.- Primary Health Care in Canada A Review Of Systems.- An Overview of Primary Health Care in South Africa and the Effect of Medical Aid Insurance on Private Practitioners.- The Health Care System of the Federal Republic of Germany.- Systems Analysis for Computers in Ambulatory Health Care in Ireland.- Primary Care Computing in the U.K..- Primary Health Care in Finland.- The Swedish Health-Care System.- Information Systems in Doctor's Office in Japan.- Structure of Primary Health Care in the Netherlands.- The Belgium Primary Care System.- Systems in Primary Care in France.- System Analysis of Primary Care in Italy: Perspectives and Problems of Computerized Information Systems.- One or Twenty-Six hHealth Care Systems in Switzerland?.- Structure of the Health System and Practical Aspects of Computer Use in Primary Care.- Primary Health Care System in Poland.- Achievements and Further Tasks of the Health and Social Services in Developing the Advanced Socialist Society in the German Democratic Republic.- Primary Health Care in Hungary.- Author Index.- Authors Addresses.