New report aims to revitalize declining primary care in the U.S. – University of California – Davis Health

Report on Revitalizing Primary Care in the U.S. with Emphasis on Sustainable Development Goals (SDGs)

Introduction

Primary care in the United States is experiencing a significant decline, prompting national health care experts to develop a comprehensive report aimed at reversing this trend. The report, released by UC Davis Health, highlights critical recommendations that align with the United Nations Sustainable Development Goals (SDGs), particularly those related to good health and well-being (SDG 3), reduced inequalities (SDG 10), and partnerships for the goals (SDG 17).

Background and Context

The report summarizes findings from a summit held at UC Davis in October, where over 100 stakeholders, including a 30-member expert committee, convened to address the crisis in primary care. This crisis is largely due to chronic underfunding, inadequate health care policy attention, and workforce planning deficiencies, resulting in a shortage of primary care clinicians and reduced access to timely, quality care.

Key Issues Identified

• Underfunding of primary care services
• Insufficient workforce diversity and numbers
• Lack of modernized payment and care delivery models
• Worsening health indicators compared to other developed countries

Recommendations to Revitalize Primary Care

The report presents seven strategic recommendations designed to improve primary care, with a strong focus on achieving SDG targets:

1. Increase Funding for Primary Care
   Double the proportion of health care dollars spent by public and private insurers on primary care, supporting SDG 3 by enhancing health systems and services.
2. Reform Payment Models
   Encourage payment structures that promote relationship-centered care, improving quality and patient outcomes.
3. Modernize Care Delivery
   Implement high-quality care models that reduce administrative burdens, facilitating efficient health service delivery.
4. Advance Health Equity
   Establish universal population health goals developed collaboratively with diverse communities to reduce inequalities, directly supporting SDG 10.
5. Expand Workforce Education and Diversity
   Ensure medical schools train a sufficiently large and diverse primary care clinician workforce, fostering inclusive health care access.
6. Enhance Primary Care Research
   Increase research efforts to better understand primary care challenges and inform evidence-based reforms.
7. Develop Multi-Stakeholder Coalitions
   Build partnerships among patients, health plans, government agencies, and other stakeholders to communicate and support the value of robust primary care, aligning with SDG 17.

Alignment with Sustainable Development Goals

• SDG 3: Good Health and Well-being – Strengthening primary care improves health outcomes and life expectancy.
• SDG 10: Reduced Inequalities – Advancing health equity ensures all populations receive quality care.
• SDG 17: Partnerships for the Goals – Collaborative coalitions enhance resource mobilization and policy implementation.

Conclusion

The report represents a critical step towards addressing the primary care crisis in the U.S. by fostering a national dialogue and encouraging adoption of these recommendations by policymakers, health systems, clinicians, and other stakeholders. The integration of SDG principles throughout the recommendations underscores the global importance of revitalizing primary care to achieve sustainable health development.

The full 50-page report is accessible on the Rev PC website.

1. Sustainable Development Goals (SDGs) Addressed or Connected to the Issues Highlighted in the Article

1. SDG 3: Good Health and Well-being
   • The article focuses on the decline of primary care in the U.S., which directly impacts health outcomes and access to quality health services.
   • Improving primary care is essential to achieving universal health coverage and better health indicators such as life expectancy.
2. SDG 4: Quality Education
   • The article emphasizes the need for medical schools to educate and train a larger and more diverse primary care workforce, linking to quality education and workforce development.
3. SDG 10: Reduced Inequalities
   • Advancing health equity through universal population health goals and collaborative approaches addresses inequalities in healthcare access and outcomes.
4. SDG 17: Partnerships for the Goals
   • The recommendation to develop coalitions with stakeholders including patients, health plans, and government agencies reflects the importance of partnerships to strengthen primary care systems.

2. Specific Targets Under Those SDGs Identified Based on the Article’s Content

1. SDG 3: Good Health and Well-being
   • Target 3.8: Achieve universal health coverage, including financial risk protection and access to quality essential health-care services.
   • Target 3.c: Increase health financing and recruitment, development, training, and retention of the health workforce in developing countries (implied by the need for a larger and diverse workforce).
2. SDG 4: Quality Education
   • Target 4.3: Ensure equal access for all to affordable and quality technical, vocational, and tertiary education, including university education (implied by the focus on medical education and training).
3. SDG 10: Reduced Inequalities
   • Target 10.2: Empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, or other status (linked to advancing health equity).
4. SDG 17: Partnerships for the Goals
   • Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships.

3. Indicators Mentioned or Implied in the Article to Measure Progress Towards the Identified Targets

1. Proportion of Health Care Spending on Primary Care
   • The article calls for doubling the proportion of health care dollars spent on primary care by public and private insurers, implying this as a measurable indicator of investment in primary care.
2. Primary Care Workforce Size and Diversity
   • Measuring the number and diversity of primary care clinicians trained and practicing is implied as an indicator to assess progress in workforce development.
3. Access to Primary Care Services
   • Indicators such as timely access to internists, pediatricians, and family medicine doctors, and patient satisfaction with appointment length and quality of care.
4. Health Equity Metrics
   • Indicators related to universal population health goals and reduction in disparities among different communities.
5. Health Outcomes
   • Life expectancy and other leading health indicators that reflect the overall effectiveness of primary care systems.
6. Coalition and Partnership Engagement
   • Number and effectiveness of coalitions formed among stakeholders to support primary care revitalization.

4. Table of SDGs, Targets, and Indicators

Source: health.ucdavis.edu