Good primary care can be described as first contact care,
continuity over time, comprehensiveness, and coordination
with other parts of the health system. The Netherlands is
increasingly recognized as a best practice model of primary
care. Methods: We used data from the Commonwealth
Fund International Health Policy Surveys of 2006–2009 to
describe the most relevant elements in the Dutch primary
healthcare system. These studies were telephone surveys
targeting random samples of three groups of respondents –
citizens, chronically ill patients, and general practitioners
(GPs) – asking their views and perceptions on a wide range
of topics. Data from Dutch observational studies of general
practices were used to complement the picture. Results:
Dutch general practices are easily accessible during office
hours as well as out-of-hours, guaranteeing reliable 24/7
access. There are no co-payments for care delivered in
general practice. Most practices, privately owned, offer a
wide range of services. Advanced practice nurses are
involved in chronic care management. Increasingly, tasks
are transferred from hospital specialists to GPs, supported
by financial incentives. Regional collaborative care groups
of GPs offer disease management programs (e.g. diabetes,
COPD). Almost 100 percent of the practices use electronic
medical records. Quality improvement in primary care
includes evidence-based guidelines, performance
indicators, and many innovative experiments. Discussion:
Bottom-up and top-down activities contributed to a
successful primary care system. Strong aspects are the 24
hour access to general practice, the advanced electronic
medical record, and the quality assessment system
predominantly driven by professionals. Lessons can be
learned from the Netherlands and may be applicable to
health policy experiments and health reforms in other
countries.