Research output on primary care in Australia, Canada, Germany, the Netherlands, the United Kingdom, and the United States: bibliometric analysisBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d1028 (Published 08 March 2011) Cite this as: BMJ 2011;342:d1028
All rapid responses
We read with interest the paper from Glanville J (1) and colleagues
about Research Output on primary care (PC) which concludes: "UK researchers
are placed among the best performed internationally". We disagree with the
methodology the authors have used for reaching that conclusion.
Only 5 countries (UK, Germany, US, Canada, Australia) are involved in the
comparison because they are countries with "well established academic primary
care". But no indicator is given about this topic. Thus, a definition of
PC from B Starfield (1992) is used. But not all these countries have
health systems with strong PC. Just the same author but in a more recent
(2) publication, 1998, made a classification of countries according to the
strength of primary care where the leading countries are UK, Netherlands,
Finland, Spain and Denmark but not Germany, US, Canada, Australia which
are included in Glanville and collaeagues' paper.
The percentage of Gross Domestic Product on Research according to OECD
statistics in the period 2000-2007 (3), shows countries such as Finland, Sweden
or Denmark rating higher for this score (3,42; 3,77 and 2,49
respectively) than UK, Germany, US, Canada, or Australia (1,76; 2,5; 2,62;
It is not clear what mesh major has been used for the search. We made a
more specific search using the mesh major: "Primary Care", "Family
Practice" "Physician Family" "Nurse practitioners" and associated entry
terms in Medline, for the period 2000-2004. We found 20911 PC articles.
Country productivity by GDP shows UK, New Zealand, Ireland, Australia,
Norway and The Netherlands as the leading productivity countries. Country
productivity by population shows UK, Ireland, Norway, Australia, New
Zealand and Denmark as the leaders. There is a high correlation between
Country productivity by population and the strength of primary care (1).
So really "UK research is placed among the best performed internationally"
but it is difficult to believe it from the paper without a wider
comparison including leading countries in primary care nowadays.
1.- Glanville J, Kendrick T, McNally R, Campbell J, Hobbs FDR.
Research output on primary care in Australia, Canada, Germany, the
Netherlands, the United Kingdom, and the United States: bibliometric
2.- Starfield B. Primary care; balancing health needs service and
technology. Oxfor Unviersity Press, 1998.
3.- Organisation for Economic Cooperation and
Development.OECD.StatExtracts [database online]. 2007.
4.- Carratala MC. Doctoral Thesis. International scientific productivity
in primary care: bibliometric analysis. University Miguel Hernandez.
Competing interests: No competing interests