[A primary care system in Germany: evidence, opportunities, and implementation]

International comparisons show that healthcare systems with strong, coordinated primary care often achieve better health outcomes while using resources more efficiently. Against this background, this narrative review, based on the available literature and data from the Organisation for Economic Co-operation and Development (OECD), provides an overview of healthcare structures, utilization, and outcomes in Germany compared with 11 other European countries and interprets the findings in the context of healthcare systems coordinated by primary care.The results show that Germany is characterized by high utilization of healthcare services and high healthcare expenditure, while at the same time performing comparatively poorly on key health indicators, particularly avoidable mortality. Stronger coordination through primary care could help improve these outcomes.At the same time, the findings highlight that the success of primary care-coordinated healthcare systems depends critically on their structural framework. In addition to sufficient primary care capacity, interprofessional teams, robust digital infrastructure, and binding mechanisms for coordination and feedback are essential prerequisites. Strengthening primary care alone, however, is not sufficient: its effectiveness requires far-reaching structural reforms and a stronger orientation of the healthcare system toward preventive measures.