Journal of Emergency Health Care

en Strengthening Primary Care: Trends and Public Health Impact of Family Medicine in East Asia, the Persian Gulf States, and Europe عمومى General مروری Review <div>Background: Family medicine (FM) is a unique medical specialty that delivers comprehensive, continuous, and coordinated care to individuals and families across all ages, health conditions, and life stages. Originating in the mid‑20th century as a response to growing fragmentation in healthcare and the proliferation of sub‑specialties, FM has since become the foundation of effective primary health care and universal health coverage. Purpose: This narrative review compares the evolution, training pathways, system integration, and public health impact of FM across East Asia (China, Japan, South Korea, Taiwan), the Persian Gulf states (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates), selected European nations (Germany, England, France), and Iran.               Method: We employed a structured literature search using PubMed and Google Scholar, complemented by an examination of WHO publications, country health ministry reports, and key textbooks, focusing on family medicine policies, training programs, delivery models, and public health outcomes.                                                                                                                Result: In East Asia, FM has transitioned from community health worker programs to formal “5 + 3” residency models, yet persistent hospital‑centered care and weak gatekeeping limit its full integration. Persian Gulf countries pioneered FM residencies in the 1980s–1990s, establishing public‑sector networks but continue to face workforce shortages and dependence on expatriate clinicians. European systems exemplify mature FM practice with structured gatekeeping (mandatory in the UK, incentivized in France, optional in Germany), multidisciplinary teams, and performance‑based preventive frameworks, yielding high immunization coverage, reduced infant mortality, and cost efficiencies. Across regions, robust FM systems consistently demonstrate lower all‑cause mortality, reduced healthcare disparities, fewer hospital admissions, and more equitable access to services. Key strategies for strengthening FM include expanding and standardizing training programs, formalizing patient registration and gatekeeping, integrating FM into community health planning, and aligning payment incentives with preventive outcomes.                                                     Conclusion: As populations age and the burden of chronic disease grows, prioritizing FM will be essential to achieving sustainable, patient‑centered health systems that deliver high‑quality, cost‑effective care.  </div> Family Medicine Primary Health Care Health Systems Continuity of Care Health Outcomes Health Economics Preventive Medicine 1 10 http://intjmi.com/browse.php?a_code=A-10-1-691&slc_lang=en&sid=1 Maryam Zarin kamar 10031947532846008404 10031947532846008404 No Assistant Professor, Department of Family Medicine, Faculty of Medicinical Sciences, e, Mazandaran University of MedSari, Iran Mojgan Geran 10031947532846008405 10031947532846008405 Yes Diabetes Research Center, Institute of Herbal Medicines and Metabolic Disorders, Mazandaran University of Medical Sciences, Sari, Iran