---
title: "Division of Responsibilities Between Primary and Specialist Care in Chronic Respiratory Disease Ma"
id: "pubmed-42800884"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42800884"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42800884/"
doi: "10.12659/MSM.954025"
published_at: "2026-09-27T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Division of Responsibilities Between Primary and Specialist Care in Chronic Respiratory Disease Ma
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42800884
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42800884/)
- **DOI:** [10.12659/MSM.954025](https://doi.org/10.12659%2FMSM.954025)
- **Published At:** 2026-09-27T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This cross-sectional survey examined healthcare professionals' perceptions of responsibility-sharing between **primary care** and **outpatient specialist care** for **chronic respiratory diseases (CRDs)** across 10 European countries. - The study was conducted within the Joint Action on REspiratory Diseases (JARED) project and collected data between October and December 2025. - A two-stage questionnaire design was used; the final analytic sample comprised 293 respondents from 10 countries. - Overall, 58% of respondents reported that the division of responsibilities between primary and specialist care was clearly defined in their setting. - When asked whether the current division was optimal, responses were split: 44% positive, 43% negative, and 13% undecided, indicating no clear consensus. - Respondents reported substantial variation in perceptions between countries, suggesting heterogeneous organization of CRD care across Europe. - The most frequently reported system-level barriers included long **waiting times** for specialist care (41%) and shortages of specialists (text truncated in source; reported as shortages of specialist personnel). - The article describes background, aims, methods, descriptive results, and perceived barriers; additional specifics such as country-level breakdowns, respondent professional mix, questionnaire items, and full list of barriers were not fully reported in the available source excerpt. - The study highlights tensions between international recommendations for integrated, primary care-led models and observed variability in real-world division of responsibilities for CRD management. - Details on response rates, sampling frames, statistical testing beyond descriptive statistics, and implications for policy or practice were not reported in the provided source abstract.
## Clinical Analysis & Structured Key Points
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Healthcare Professionals' Perceptions of the Division of Responsibilities Between Primary and Outpatient Specialist Care in Chronic Respiratory Disease Management: A Cross-Sectional Survey in 10 European Countries [Paulina Mularczyk-Tomczewska](https://pubmed.ncbi.nlm.nih.gov/?term=Mularczyk-Tomczewska+P&cauthor_id=42800884)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-1 "Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland."), [Mateusz Jankowski](https://pubmed.ncbi.nlm.nih.gov/?term=Jankowski+M&cauthor_id=42800884)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-2 "School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland."), [Hanna Nurmi](https://pubmed.ncbi.nlm.nih.gov/?term=Nurmi+H&cauthor_id=42800884)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-3 "Finnish Lung Health Association, Helsinki, Finland."), [Ildiko Horvath](https://pubmed.ncbi.nlm.nih.gov/?term=Horvath+I&cauthor_id=42800884)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-4 "National Koranyi Institute of Pulmonology, Budapest, Hungary."), [Tuula Maarit Vasankari](https://pubmed.ncbi.nlm.nih.gov/?term=Vasankari+TM&cauthor_id=42800884)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-3 "Finnish Lung Health Association, Helsinki, Finland."), [Cristina Bárbara](https://pubmed.ncbi.nlm.nih.gov/?term=B%C3%A1rbara+C&cauthor_id=42800884)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-5 "Instituto de Saúde Ambiental \(ISAMB\), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal."), [Kristina Bieksiene](https://pubmed.ncbi.nlm.nih.gov/?term=Bieksiene+K&cauthor_id=42800884)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-6 "Department of Pulmonology, Lithuanian University of Health Sciences, Kaunas, Lithuania."), [Andrea Vukić Dugac](https://pubmed.ncbi.nlm.nih.gov/?term=Vuki%C4%87+Dugac+A&cauthor_id=42800884)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-7 "School of Medicine, University of Zagreb, Zagreb, Croatia.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-8 "University Hospital Center Zagreb, Clinic for Respiratory Diseases, Zagreb, Croatia."), [Ibon Eguiluz-Gracia](https://pubmed.ncbi.nlm.nih.gov/?term=Eguiluz-Gracia+I&cauthor_id=42800884)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-9 "Allergy Unit, Hospital Regional Universitario de Malaga and IBIMA-Platafoma BIONAND, RICORS Inflammatory Diseases, Malaga, Spain."), [Beatrice Mahler](https://pubmed.ncbi.nlm.nih.gov/?term=Mahler+B&cauthor_id=42800884)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-10 "Department of Pneumology, "Marius Nasta" Institute of Pneumology, Bucharest, Romania.")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-11 ""Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania."), [Antti Pekka Saarinen](https://pubmed.ncbi.nlm.nih.gov/?term=Saarinen+AP&cauthor_id=42800884)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-12 "Central Finland Wellbeing County, Finnish Lung Health Association, Helsinki, Finland."), [Bolesław Samoliński](https://pubmed.ncbi.nlm.nih.gov/?term=Samoli%C5%84ski+B&cauthor_id=42800884)[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-13 "Department of Prevention of Environmental Hazards, Allergology and Immunology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland."), [Ilze Straume](https://pubmed.ncbi.nlm.nih.gov/?term=Straume+I&cauthor_id=42800884)[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-14 "Centre for Disease Prevention and Control of Latvia, Riga, Latvia."), [Brigid Unim](https://pubmed.ncbi.nlm.nih.gov/?term=Unim+B&cauthor_id=42800884)[ 15 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-15 "Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy."), [Filip Raciborski](https://pubmed.ncbi.nlm.nih.gov/?term=Raciborski+F&cauthor_id=42800884)[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#full-view-affiliation-13 "Department of Prevention of Environmental Hazards, Allergology and Immunology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.") Affiliations Expand ### Affiliations * 1 Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland. * 2 School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland. * 3 Finnish Lung Health Association, Helsinki, Finland. * 4 National Koranyi Institute of Pulmonology, Budapest, Hungary. * 5 Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal. * 6 Department of Pulmonology, Lithuanian University of Health Sciences, Kaunas, Lithuania. * 7 School of Medicine, University of Zagreb, Zagreb, Croatia. * 8 University Hospital Center Zagreb, Clinic for Respiratory Diseases, Zagreb, Croatia. * 9 Allergy Unit, Hospital Regional Universitario de Malaga and IBIMA-Platafoma BIONAND, RICORS Inflammatory Diseases, Malaga, Spain. * 10 Department of Pneumology, "Marius Nasta" Institute of Pneumology, Bucharest, Romania. * 11 "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. * 12 Central Finland Wellbeing County, Finnish Lung Health Association, Helsinki, Finland. * 13 Department of Prevention of Environmental Hazards, Allergology and Immunology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland. * 14 Centre for Disease Prevention and Control of Latvia, Riga, Latvia. * 15 Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy. * PMID: **42800884** * DOI: [ 10.12659/MSM.954025 ](https://doi.org/10.12659/msm.954025) Item in Clipboard # Healthcare Professionals' Perceptions of the Division of Responsibilities Between Primary and Outpatient Specialist Care in Chronic Respiratory Disease Management: A Cross-Sectional Survey in 10 European Countries Paulina Mularczyk-Tomczewska et al. Med Sci Monit. 2026. Show details Display options Display options Format Abstract PubMed PMID Med Sci Monit Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Med+Sci+Monit%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Med+Sci+Monit%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42800884/) . 2026 Sep 27:32:e954025. doi: 10.12659/MSM.954025. ### Authors [Paulina Mularczyk-Tomczewska](https://pubmed.ncbi.nlm.nih.gov/?term=Mularczyk-Tomczewska+P&cauthor_id=42800884)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-1 "Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland."), [Mateusz Jankowski](https://pubmed.ncbi.nlm.nih.gov/?term=Jankowski+M&cauthor_id=42800884)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-2 "School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland."), [Hanna Nurmi](https://pubmed.ncbi.nlm.nih.gov/?term=Nurmi+H&cauthor_id=42800884)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-3 "Finnish Lung Health Association, Helsinki, Finland."), [Ildiko Horvath](https://pubmed.ncbi.nlm.nih.gov/?term=Horvath+I&cauthor_id=42800884)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-4 "National Koranyi Institute of Pulmonology, Budapest, Hungary."), [Tuula Maarit Vasankari](https://pubmed.ncbi.nlm.nih.gov/?term=Vasankari+TM&cauthor_id=42800884)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-3 "Finnish Lung Health Association, Helsinki, Finland."), [Cristina Bárbara](https://pubmed.ncbi.nlm.nih.gov/?term=B%C3%A1rbara+C&cauthor_id=42800884)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-5 "Instituto de Saúde Ambiental \(ISAMB\), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal."), [Kristina Bieksiene](https://pubmed.ncbi.nlm.nih.gov/?term=Bieksiene+K&cauthor_id=42800884)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-6 "Department of Pulmonology, Lithuanian University of Health Sciences, Kaunas, Lithuania."), [Andrea Vukić Dugac](https://pubmed.ncbi.nlm.nih.gov/?term=Vuki%C4%87+Dugac+A&cauthor_id=42800884)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-7 "School of Medicine, University of Zagreb, Zagreb, Croatia.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-8 "University Hospital Center Zagreb, Clinic for Respiratory Diseases, Zagreb, Croatia."), [Ibon Eguiluz-Gracia](https://pubmed.ncbi.nlm.nih.gov/?term=Eguiluz-Gracia+I&cauthor_id=42800884)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-9 "Allergy Unit, Hospital Regional Universitario de Malaga and IBIMA-Platafoma BIONAND, RICORS Inflammatory Diseases, Malaga, Spain."), [Beatrice Mahler](https://pubmed.ncbi.nlm.nih.gov/?term=Mahler+B&cauthor_id=42800884)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-10 "Department of Pneumology, "Marius Nasta" Institute of Pneumology, Bucharest, Romania.")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-11 ""Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania."), [Antti Pekka Saarinen](https://pubmed.ncbi.nlm.nih.gov/?term=Saarinen+AP&cauthor_id=42800884)[ 12 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-12 "Central Finland Wellbeing County, Finnish Lung Health Association, Helsinki, Finland."), [Bolesław Samoliński](https://pubmed.ncbi.nlm.nih.gov/?term=Samoli%C5%84ski+B&cauthor_id=42800884)[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-13 "Department of Prevention of Environmental Hazards, Allergology and Immunology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland."), [Ilze Straume](https://pubmed.ncbi.nlm.nih.gov/?term=Straume+I&cauthor_id=42800884)[ 14 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-14 "Centre for Disease Prevention and Control of Latvia, Riga, Latvia."), [Brigid Unim](https://pubmed.ncbi.nlm.nih.gov/?term=Unim+B&cauthor_id=42800884)[ 15 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-15 "Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy."), [Filip Raciborski](https://pubmed.ncbi.nlm.nih.gov/?term=Raciborski+F&cauthor_id=42800884)[ 13 ](https://pubmed.ncbi.nlm.nih.gov/42800884/#short-view-affiliation-13 "Department of Prevention of Environmental Hazards, Allergology and Immunology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.") ### Affiliations * 1 Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland. * 2 School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland. * 3 Finnish Lung Health Association, Helsinki, Finland. * 4 National Koranyi Institute of Pulmonology, Budapest, Hungary. * 5 Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal. * 6 Department of Pulmonology, Lithuanian University of Health Sciences, Kaunas, Lithuania. * 7 School of Medicine, University of Zagreb, Zagreb, Croatia. * 8 University Hospital Center Zagreb, Clinic for Respiratory Diseases, Zagreb, Croatia. * 9 Allergy Unit, Hospital Regional Universitario de Malaga and IBIMA-Platafoma BIONAND, RICORS Inflammatory Diseases, Malaga, Spain. * 10 Department of Pneumology, "Marius Nasta" Institute of Pneumology, Bucharest, Romania. * 11 "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. * 12 Central Finland Wellbeing County, Finnish Lung Health Association, Helsinki, Finland. * 13 Department of Prevention of Environmental Hazards, Allergology and Immunology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland. * 14 Centre for Disease Prevention and Control of Latvia, Riga, Latvia. * 15 Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy. * PMID: **42800884** * DOI: [ 10.12659/MSM.954025 ](https://doi.org/10.12659/msm.954025) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract BACKGROUND Chronic respiratory diseases (CRDs), including asthma and chronic obstructive pulmonary disease, represent a major public health challenge in Europe. Despite international recommendations promoting integrated, primary care-led models, the organization and division of responsibilities between primary and specialist care vary across countries. The aim of this exploratory study was to describe healthcare professionals' perceptions regarding the division of responsibilities between primary and specialist care in CRD management across selected European countries and to identify perceived system-level barriers. MATERIAL AND METHODS This cross-sectional, questionnaire-based study was conducted within the Joint Action on REspiratory Diseases (JARED) project. Data were collected between October and December 2025 from healthcare professionals involved in CRD management. A 2-stage survey design was applied. The final analytical sample included 293 respondents from 10 European countries. Descriptive statistics were used to evaluate the perceived division of responsibilities and barriers to care. RESULTS Overall, 58% of respondents considered the division of responsibilities between primary and specialist care to be clearly defined. Assessments of the optimality of the current division of responsibilities were similarly distributed, with 44% positive, 43% negative, and 13% undecided. Substantial variation between countries was observed. The most frequently reported barriers were long waiting times for specialist care (41%) and shortages of specialis
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