Abstract
AIM: This study provides an updated overview of primary care for children and adolescents across Europe, investigating how systems are evolving and identifying progress and persistent gaps in healthcare models, workforce challenges and digital health integration. This study draws implications for policy makers to improve the quality of paediatric care in Europe. METHODS: A cross-sectional survey was conducted among national delegates of the European Academy of Paediatrics and the European Confederation of Primary Care Paediatricians. Respondents from 42 member countries provided standardised, national-level data on real-world implementation. RESULTS: Paediatrician-led, general practitioner-led, and combined models were reported in 28.6%, 26.2% and 45.2% of 42 countries, respectively. Eight countries (28.6%) changed their delivery models between 2010 and 2024, most transitioning toward combined care. Paediatricians' involvement declined with patient age, while general practitioners' involvement increased. Only 35.9% of countries achieved fully interoperable electronic health records. Preventive care delivery, adolescent health visits and training duration in primary paediatric care revealed critical gaps. CONCLUSIONS: Despite progress in care integration and digital uptake, major disparities remain for adolescents, digital infrastructure and training quality. Future paediatric primary care models must harmonise training, address regional disparities and invest in interoperable digital health systems to ensure equitable, high-quality care.