Primary Care: A Critical Review of the Evidence on the Quality and Costs of Health Care

Despite contentious debate over health systems reform, there is an emerging consensus that strengthening primary care will improve health outcomes and restrain the growth of health care spending. Policy discussions imply three general definitions of “primary care”: a specialty of medical providers, a set of functions served by a usual source of care, and an orientation of health systems. The authors review the empirical evidence linking each definition of primary care to health care quality, outcomes, and costs. Available evidence most directly supports enhancing the ability of providers to serve primary care functions and reorienting health systems towards primary care.