On Monday 15 September 2025, Luxembourg’s National Health Observatory published its report Primary Care in Luxembourg – A Consensus Definition, which provided the first functional definition of primary care in Luxembourg.
In the absence of a nationally anchored legal definition of primary care, the National Health Observatory said its report “establishes the first functional definition of primary care in Luxembourg, based on international definitions and adapted to national specificities”.
According to the report, primary care plays a crucial role in promoting health, preventing disease, enabling early detection, ensuring continuity of care, guiding patients to specialists and supporting post-hospitalisation follow-up. It was developed through a collective understanding and drew on the manual Implementing the Primary Health Care Approach – A Primer published in 2024 by the World Health Organization (WHO) and the European Observatory on Health Systems and Policies.
The new publication defines primary care in Luxembourg according to four essential functions: first point of contact with the healthcare system, comprehensiveness, continuity and care coordination. The National Health Observatory said that with these four fundamental objectives for primary care established for Luxembourg, the report presents the scope of primary care as perceived by key stakeholders and characterised primary care according to three groups of variables addressing the following questions:
• Which services should be included in primary care?
• Which infrastructures provide primary care?
• Which healthcare professionals deliver primary care?
Through a collaborative and consensual approach, the report aimed to gather the highest possible level of agreement and support among national health system stakeholders by inviting them to provide structured feedback on a series of proposals. Participants in this consultation included healthcare professionals, care institutions, policymakers, educational and research institutions, regulatory and social security bodies, health insurance institutions and healthcare system users.
The National Health Observatory noted that the “richness and quality of their contributions proved essential to the development of this definition”.
They highlighted that the working definition is based on a collective understanding rather than a formal legal basis and provided a framework to unify practices, structure care around a common core and guide health policies toward shared objectives. They added that the consensus approach also informed discussions with a view to possible legal formalisation.
In practice, the definition applied to different medical and health professions, depending on their location and the nature of the procedures performed. For example, in Luxembourg, a curative procedure performed in an office by a general practitioner or paediatrician is considered primary care, while the same procedure in a specialised hospital unit is not.
According to the National Health Observatory, by precisely identifying the professionals involved and the proportion of their activity dedicated to primary care, it became possible to measure and map the allocation of resources to primary care by listing existing structures and providers. This facilitated the identification of underserved areas and supported policies aimed at ensuring equitable access to care.
They added that beyond the immediate benefits, this definition also offered medium-term perspectives. In particular, it allowed for a systematic evaluation of primary care performance by measuring the effectiveness, quality of primary care and supported the continuous improvement of the health system by identifying strengths, weaknesses and areas for improvement, laying the foundation for more strategic and sustainable management of the health system.
The National Health Observatory concluded: “This functional definition, derived from a consensus-based approach, constitutes a central strategic tool for structuring, managing and sustainably improving primary care in Luxembourg. It strengthens a common understanding of primary care, promotes a coherent and targeted approach to primary care, supports resource planning and paves the way for rigorous and continuous evaluation of the performance of front-line services.”
