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Research output on primary care in Australia, Canada, Germany, the Netherlands, the United Kingdom, and the United States: bibliometric analysis

BMJ 2011; 342 doi: (Published 08 March 2011) Cite this as: BMJ 2011;342:d1028
  1. Julie Glanville, project director1,
  2. Tony Kendrick, head of primary care26,
  3. Rosalind McNally, outreach librarian3,
  4. John Campbell, head of primary care 4,
  5. FD Richard Hobbs, head of primary care56
  1. 1York Health Economics Consortium, University of York
  2. 2Department of Primary Care, University of Southampton
  3. 3National Primary Care Research and Development Centre, University of Manchester
  4. 4Department of Primary Care, Peninsula Medical School
  5. 5Department of Primary Care Clinical Sciences, University of Birmingham
  6. 6NIHR National School for Primary Care Research
  1. Correspondence to: F D R Hobbs, Primary Care Clinical Sciences Building, University of Birmingham, Edgbaston, Birmingham B15 2TT f.d.r.hobbs{at}
  • Accepted 2 January 2011


Objective To compare the volume and quality of original research in primary care published by researchers from primary care in the United Kingdom against five countries with well established academic primary care.

Design Bibliometric analysis.

Setting United Kingdom, United States, Australia, Canada, Germany, and the Netherlands.

Studies reviewed Research publications relevant to comprehensive primary care and authored by researchers from primary care, recorded in Medline and Embase, with publication dates 2001-7 inclusive.

Main outcome measures Volume of published activity of generalist primary care researchers and the quality of the research output by those publishing the most using citation metrics: numbers of cited papers, proportion of cited papers, and mean citation scores.

Results 82 169 papers published between 2001 and 2007 in the six countries were classified as research on primary care. In a 15% pragmatic random sample of these records, 40% of research on primary care from the United Kingdom and 46% from the Netherlands was authored by researchers employed in a primary care setting or employed in academic departments of primary care. The 141 researchers with the highest volume of publications reporting research findings published between 2001 and 2007 (inclusive) authored or part authored 8.3% of the total sample of papers. For authors with the highest proportion of publications cited at least five times, the best performers came from the United States (n=5), United Kingdom (n=4), and the Netherlands (n=2). In the top 10 of authors with the highest proportions of publications achieving 20 or more citations, six were from the United Kingdom and four from the United States. The mean Hirsch index (measure of a researcher’s productivity and impact of the published work) was 14 for the Netherlands, 13 for the United Kingdom, 12 for the United States, 7 for Canada, 4 for Australia, and 3 for Germany.

Conclusion This international comparison of the volume and citation rates of papers by researchers from primary care consistently placed UK researchers among the best performers internationally.


  • We thank the following primary care academics who, in addition to the authors, compared the search generated publication lists with their own records in two rounds of validation checks: Marin Roland, Helen Smith, Brendan Delaney, Paul Little, Paul Wallace, and Bob McKinlay; the input of Kath Wright, Kate Light, Lindsey Myers, Su Golder, Steven Duffy, Kate Misso, David Fox, and Lisa Stirk from the Centre for Reviews and Dissemination at the University of York who assisted with the development of the search strategy and the categorisation of primary care research records; statistical assistance from Andrew Jones. Part of this research was carried out while JG was employed at the Centre for Reviews and Dissemination, University of York, and completed while employed at the York Health Economics Consortium.

  • Contributors: All authors contributed to the study design. JG led the bibliometric reviewing and preliminary analysis. FDRH and JG led the preliminary interpretation, to which all authors contributed. FDRH and JG drafted the paper and are guarantors. All authors edited the final paper.

  • Funding: This study was jointly funded by the Society for Academic Primary Care and the National Institute for Health Research (NIHR) National School for Primary Care Research.

  • Competing interests: All authors have completed the Unified Competing Interest form at (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; most of the authors (TK, RM, JC, FDRH) are UK primary care researchers, and TK and FDRH competed in the Research Assessment Exercise 2008. FDRH is director of the National Institute for Health Research School for Primary Care Research.

  • Ethical approval: Not required.

  • Data sharing: No additional data available.

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