The French health system is marked by a deficiency in medical demography which impacts the management of front-line care (general practitioners, emergency services). The liberal configuration of this health system allows any doctor to choose their place of exercise, which strengthens the territorial inequalities of access to care linked to both the aging of the population and the retirements of non-replaced practitioners.In response to the deterioration of the density of general practitioners, we sought to understand whether patients were turning to other forms of front-line care (emergency services, teleconsultation platform, out-of-region consultations, etc.) and to assess the impact of these developments on the health of populations.This research is based on a longitudinal study in the 385 "territories experienced by general practitioners" identified in the Centre-Val-de-Loire region between 2013 and 2022. Healthcare data from the SNDS databases SNIIRAM and DCIRS-PMSI (general practice procedures and services, emergency department visits, teleconsultations, unscheduled care), and epidemiological data from Santé publique France (Géodes), are analyzed using multivariate methods (Comparative Consumption Index, Principal Component Analysis, and Hierarchical Agglomerative Clustering).The results show a significant drop in ten years of consultations with general practitioners at the regional level (-20 %). At the same time, emergencies without hospitalisation are barely increasing (+0.1%), consultations within and outside the region have fallen sharply (-2 million consultations, i.e. -52%), and we can see a timid appearance of teleconsultations. Only 10% of the shortfall in consultations in offset by emergencies and teleconsultations, with strong infra regional disparities.These spatial inequalities reflect the systemic effect linked not only to the decrease in the effective density of general practitioners, but also a pejoration of the state of health of the populations of certain "territories experienced" by the mechanism of renunciation of care of first lines by the different most disadvantaged populations.This shows, firstly, that the choice of territory, the geographical divisions used, change the vision of these inequalities, and secondly the importance for public policy of equipping itself with territorial observation tools that are as close to the reality as possible, corresponding to the care practices of patients and carers.

Population is generally defined as a community of people living in the same geographical area, particularly in the context of community-oriented primary care. However, in many countries, including Türkiye, GP’s  provide services to the population registered on their patient lists.This study aimed to examine the geographical coverage of Family Health Centers operating with patient lists in the districts of Tuzla, Sultanbeyli, and Pendik in XXX.This quantitative, descriptive, and cross-sectional study was conducted in six Primary Care Centers (Family Health Center -FHC) selected through convenience sampling, with two centers from each district. With a 99% confidence level and an unknown population size, the required sample size was calculated as 664. Assuming a 40% non-response rate, 928 individuals were planned to be included, corresponding to 155 participants per center. Adults aged ≥18 years registered at the FHCs were randomly selected. Selected individuals were contacted by phone, and those who agreed to participate and signed the consent form completed a pre-designed questionnaire.A total of 598 participants completed the study. Of these, 51% were women and 49% were men, with a mean age of 40.6 .The most common reasons for FHC visits were upper respiratory infections or minor health problems (40.1%) and prescription renewal (30.1%). The proportion of participants living within 0–500 meters of their FHC was 46%, and those living within 0–1000 meters reached 77.9%. Overall, 90.4% lived within 2000 meters. A total of 76.1% accessed the FHC on foot, while 23.9% used a vehicle. Participants residing within 0–500 meters applied to the FHC more frequently—both within the last 3 months and within the last year.The study shows that in the patient-list–based family medicine service provision, individuals predominantly select FHCs close to their residence, and proximity facilitates access to services.These findings suggest that geographical coverage can be achieved through patient lists even within community-oriented primary care models.

Fifteen percent of XXX patients lack access to regular primary care providers (PCP) i.e., family physicians or nurse practitioners.These patients are referred to as unattached patients. PCPs are the first point of contact patients have with the healthcare system. Primary care is a crucial component of the healthcare system and is important to providing the first line of care, prevention of illness and mortality, and referral to specialists. Attachment to a PCP is associated with better health outcomes such as timely treatment, better management of chronic illness, lower likelihood of unmet health needs or undiagnosed conditions, and better health outcomes.To delineate patients’ attachment status, ways of gaining attachment, time to attachment, preferences for, and attachment to different PCP types.We conducted a cross-sectional survey with patients across three XXX provinces, XXX, XXX, and XXX. The survey was conducted online over a two-week period in November 2025. Descriptive statistics were conducted on key variables including patient attachment status, provider attachment type, ways of finding a provider, and time to attachment.The survey was sent to 3202 patients with 2571 patients completing the survey. Approximately 25%, 15%, and 32% of patients did not currently have a PCP in XXX, XXX, and XXX, respectively. Nearly 86%, 95%, and 93% of attached patients were attached to a family physician. The top way of getting connected to PCPs was through family members in XXX and XXX, and through Guichet d'accès à un médecin de famille (GAMF, the patient registry) in XXX. Approximately 39%, 56%, and 35% of patients waited less than one year to get attached to a PCP in XXX, XXX, and XXX.Early findings suggest differences in both the proportion of attached patients and the rates of attachment in the three provinces. Family doctors are also the main provider type patients are attached to, and there is a preference for attachment to a family doctor.The findings from this cross-provincial survey will be used to inform research, policy, and practice with respect to improving access to primary care for patients.

Several European regions face persistent difficulties in ensuring access to primary care due to GP shortages, demographic pressures, and increasing care needs. Territorial health organisations have been mandated to improve population coverage, particularly by facilitating access to a regular general practitioner (GP). This study assessed the implementation and perceived effectiveness of a structured access initiative targeting individuals without a GP.To assess the acceptability, and perceived feasibility of a territorial scheme designed to secure a regular GP for patients lacking one.A cross-sectional study was conducted among patients and GPs participating in the initiative. Participants completed a structured satisfaction survey assessing accessibility, clarity of information, perceived barriers, and continuity of care. Descriptive analyses were performed.Among 104 eligible patients, 43 participated (41%). Most were women (63%) and reported long-term conditions (84%). Despite 65% requiring assistance to complete the request form, most found the procedure easy. Satisfaction with initial contact was universal, and 86% reported timely outreach. Appointment timeliness (76% satisfied) and practice distance (85% satisfied) were positively rated. Continuity was high: 86% were still followed by the assigned GP, who had become their regular doctor in most cases. Recommendation intention was strong (74%). Fourteen of 44 participating GPs responded (32%). Most worked in multidisciplinary practices (64%) and judged the information provided as clear or sufficient (71%). Most integrated only a small number of patients. Half reported organisational adjustments, mainly longer consultations. Missing clinical information was frequently mentioned as a barrier. Nonetheless, 86% would participate again, and 93% would recommend the scheme.Findings suggest that a structured territorial approach can enhance access to a regular GP for patients without one, with high levels of satisfaction and sustained continuity of care. GP engagement was positive, although operational constraints, particularly incomplete information transfer and increased workload, may limit scalability. Strengthening clinical information flow and organisational support appears essential for sustainable implementation. Such initiatives may constitute a valuable contribution to mitigating primary care shortages and promoting equitable access in underserved areas.The scheme demonstrates high acceptability and offers a promising model for improving access to primary care in contexts of limited GP availability.

A detailed understanding of accessibility to healthcare is vital to support healthcare professionals, universities and political decision-makers in developing sustainable healthcare provision in Belgium. Accessibility to healthcare is a widely debated concept, often in binary terms: financial accessibility and/or the density of doctors per population. Unfortunately, the issue is much more complex and subjective.A detailed understanding of accessibility to healthcare is vital to support healthcare professionals, universities and political decision-makers in developing sustainable healthcare provision in Wallonia. Accessibility to healthcare is a widely debated concept, often in binary terms: financial accessibility and/or the density of doctors per population. Unfortunately, the issue is much more complex and subjective.This studie aim is to identify whether there are any difficulties in accessing GPs, potential accessibility problems and geographical variations. The aim is also to identify the predominant independent variables (distance, travel time, other factors) impacting on accessibility difficulties.We surveyed a panel of Belgian citizens through the "The Social Study" project call: the TSS panel comprises a representative group of 5,000 Belgian citizens aged 16 and over, randomly selected from the national register. The scientific committee selected 1,042 panelists residing in the Walloon Region. The response rate was 81.77% (n=852). Data collection took place between December 2, 2024, and February 4, 2025, using either an electronic or paper questionnaire to avoid technological bias. After cleaning the database, 801 responses were used (76.87% of the panel).Approximately 25% of panelists reported having difficulty finding a general practitioner. The reasons are varied. For example, about 6% postpone an appointment due to cost. Patients whose health requires a home visit have more difficulty finding a general practitioner.This is an exploratory study preceding a qualitative study.Our study allows us, on the one hand, to establish an observation on the difficulties of access to general practitioners in the French-speaking part of Belgium and, on the other hand, to establish hypotheses on the causes of these difficulties;

Catalonia has a recognized pediatric primary care model. However, social, demographic, and health changes, together with territorial inequalities and coordination gaps, make it necessary to redefine the model to guarantee equitable and comprehensive care. Scientific evidence confirms that care provided by pediatricians and specialized pediatric nurses improves child health outcomes. Objective is to ensure integrated, coordinated, accessible, and high-quality pediatric care across Catalonia through the progressive implementation of Territorial Pediatric Care Teams (ETAP), reducing disparities, ensuring homogeneous access to services, and achieving improved health outcomes.A quantitative and qualitative analysis of the current situation was conducted, including territorial distribution, vacant positions, retirement forecasts, ETAP implementation status, and care indicators. Based on these results, a strategic plan was defined to include team creation and expansion, service portfolio, resource allocation, and a monitoring system based on indicators.Key lessons learned include the importance of collaborative leadership, clear communication with professionals and families, and technological adaptation to improve accessibility. The future plan aims to expand coverage from 36% to 55% during the first semester of 2026, consolidate the service portfolio, and integrate digital innovation to ensure sustainability and continuous improvement.Implementation faces challenges such as institutional recognition, infrastructure adequacy, resistance to change, technological limitations, and public acceptance. Strategies include collaborative leadership, clear communication, and active involvement of professionals and families. The project is based on principles guiding ETAP organization: professional autonomy for responsible clinical decisions; territorial equity to ensure equal access to services, prevention, and scientific innovation; and cohesion to foster interprofessional collaboration, resource solidarity, and an integrated vision of child health.ETAP deployment is a strategic commitment to consolidate a territorial, integrated, and sustainable pediatric care model that guarantees equity and quality in health.