The Barbara Starfield collection

The 'Case for Primary Care'

There is now good evidence, from a variety of studies at national, state, regional, local, and individual levels that good primary care is associated with better health outcomes (on average), lower costs (robustly and consistently), and greater equity in health. Starfield

Professor Barbara Starfield championed the value and need of strong primary health care systems worldwide. This collection emphasizes the case for primary care and includes a number of Barbara Starfield's own articles as well as other key related material.

Remembering Barbara Starfield (2021 Tribute)

Welcome to a special tribute dedicated to Professor Barbara Starfield, the most influential figure in family medicine whose remarkable work and contributions positively influenced the perception of Primary Care as a fundamental element for communities well-being and global health.

It has been a decade since Professor Starfield passed away, on 10th June, 2011. We honour her memory and legacy with a special section full of inspiring stories, personal anecdotes and heartfelt messages from WONCA members and close colleagues. A special thanks to Dr Karen Kinder and everyone who made this tribute possible!

About Professor Barbara Starfield

Professor Barbara Starfield (1932-2011), a physician and health services researcher, was university distinguished professor and professor of health policy and pediatrics at Johns Hopkins University. She is internationally known for her work in primary care, and her books are widely recognized as the seminal works in the field. She was instrumental in leading projects to develop important methodological tools, including the Primary Care Assessment Tool (PCAT), the CHIP tools (to assess adolescent and child health status), and the Johns Hopkins Adjusted Clinical Groups (ACGs) for assessment of diagnosed morbidity burdens reflecting degrees of co-morbidity. She was the co-founder and first president of the International Society for Equity in Health, a scientific organization devoted to dissemination of knowledge about the determinants of inequity in health and ways to eliminate them. Her work focused on quality of care, health status assessment, primary care evaluation, and equity in health, She was a member of the Institute of Medicine, serving on its governing council. She was a member of the National Committee on Vital and Health Statistics and many other government and professional committees and groups.

More from Johns Hopkins about Starfield and here

Barbara Starfield memorial page

Richard Roberts' testimonial to Barbara Starfield June 2011

Barbara Starfield's Primary Care

Primary Care Part I: Selected Presentations and A Course in Primary Care

Description: Part I of Prof Starfield's update of her seminal books, Primary Care: Concept, Evaluation, and Policy and Primary Care: Balancing Health Needs, Services, and Technology, comprises six invited lectures plus an 11 lecture course that examines the meaning, practice, and effectiveness of primary care. Topics include disease, morbidity, primary care innovations, health equities and disparities, prevention, and specialist care. The course is freely available online.
ISBN: 0-19-507489-0

Barbara Starfield publications: the case for Primary Care

Starfield B. Is patient centered care the same as person focused care. Perm J. 2011 Spring;15(2):63-9
Starfield B. The hidden inequity in health care. Int J Equity Health. 2011; 10: 15.pubished online doi: 10.1186/1475-9276-10-15
Starfield B. Family medicine should shape reform, not vice versa. Fam Pract Manag 2009;16:6-7
Starfield B. Toward international primary care reform. CMAJ 2009;180:1091-2
Starfield B. Comprehensiveness of care; consent and importance. Presentation given in New Zealand. 2009 Feb
Starfield B. An evidence base for primary care. Inteview by John Marcille. Manag Care 2008;17:33-9
Rawaf S, De Maeseneer J, Starfield B. From Alma-Ata to Almaty: a new start for primary health care. The Lancet 2008;372:1365-7
Starfield B. Global health equity and primary care. J Am Board Fam Med. 2007 Nov-Dec;20(6):511-3
Starfield B. The future of primary care: refocusing the system. N Engl J Med 2008;359:2087-91.
Starfield B. Pathways of influence on equity in health. Soc Sci Med 2007; 64 (7): 1355-62.
Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q 2005; 83: 457-502.
Starfield B, Shi L, Grover A, Macinko J. The effects of specialist supply on populations' health: assessing the evidence. Health Affairs 2005; W5: 97-107
Starfield B, Shi L. Policy-relevant determinants of health: an international perspective. Health Policy 2002; 60: 201-18.
Starfield B. Is primary care essential? Lancet 1994; 344: 1129-33.
Starfield B. Primary care and health: a cross-national comparison. JAMA 1991; 266(15): 2268-71.
Starfield B. Measuring the attainment of primary care. J Med Educ 1979; 54: 361-9.
Starfield B. Measurement of outcome: a proposed scheme. Milbank Q 1974; 52: 39-50.
Starfield B. Health services research: a working model. N Engl J Med 1973; 289: 132-6.

Other key publications

The Declaration of Alma Ata 1978

van Lerberghe W, Evans T, Rasanathan K, Mechbal A: The World Health Report 2008 – Primary Health Care – Now More Than Ever. Geneva: World Health Organisation; 2008. 119 pages
Download full document here
Download summary document here

The Declaration of Astana
WHO Special Programme on PHC