Effect of an integrated care model for pre-frail and frail older people living in community

The objective of this article is to evaluate the effect of an integrated care model for pre-frail and frail community-dwelling older people.

Continuity and coordination of care at the heart of integrated people-centred health services (IPCHS)

There are many descriptions of integrated care. I particularly relate to one framed by National Voices: ‘’My care is planned with people who work together to understand me and my carer(s), put me in control, coordinate and deliver services to achieve my best outcomes.”  It speaks of a collaborative approach to achieve what really matters to the individual and their carer(s) and places coordination of care and support at the heart of integrated care.  For without effective coordination, even the most holistic care plan still leads to fragmented care, duplication, waste and harm.  

Continuity and coordination are vital, now more than ever. With increasing specialisation in healthcare, people meet many providers and frequently move between various teams at different points in the system as they experience multiple episodes of health and social care. At best, this may be well intentioned pursuit of the best quality care from the ...

Maturity requirements of a Good Practice – Using the SCIROCCO tool to assess them

The SCIROCCO self-assessment tool is an online self- assessment tool with an objective to assess a region’s readiness for integrated care. It builds on the conceptual Maturity Model for Integrated Care developed by the B3 Action Group on Integrated Care of the European Innovation Partnership on Active and Healthy Ageing.

The SCIROCCO tool helps regions to:

• Understand the strengths and weaknesses of their regional context for integrated care  and inform national, regional and local policy-makers about potential areas of  improvement;
• Adopt and transfer integrated care good practices by identifying their maturity  requirements and requirements for the potential transferability and scaling-up;
• Facilitate multi-stakeholder dialogues on progress towards the implementation and  delivery of integrated care;
• Facilitate twinning and coaching activities that help regions and organisations to better  understand the local conditions that enable the successful deployment of integrated care.

The SCIROCCO tool has been tested in more than 60 and organisations ...

SCIROCCO Exchange - Capacity-building support for integrated care

Integrated care is a recognised solution to address the challenge of ageing population. Hence, it is important to commit to opportunities that increase the readiness and capacity of regions to implement integrated care. Knowledge transfer has been greatly recognised as an effective enabler of capacity-building support. However, effective knowledge transfer and capacity-building support requires dedicated support and infrastructure to ensure that the flow of appropriate information and knowledge between adopting and transferring entities is tailored to the local context and maturity of the particular healthcare system seeking the support. This is a precondition to help health and care authorities to build their capacity for the successful transition towards integrated care.

Care providers, access to care, and the Long-term Care Nursing Insurance in China: An agent-based simulation

China piloted a publicly funded Long-term Care Nursing Insurance (LTCNI) with an aim to improve access to long-term care (LTC) for older people in China in 2012. Existing studies showed that the scheme has been successful in meeting some goals, but little is known on how the availability, price and quality of the local care providers affect access to care. This article founded considerable discrepancies in terms of access to services among the LTCNI beneficiaries. The poor are more likely to choose nursing home care with low costs albeit these services may be of poor quality. The demand for home-based services is high, but these services are not distributed according to population needs and are not available in some districts with high concentration of older people. 

A 10 Step Framework to Implement Integrated Care for Older Persons

An aging population, whose multi-morbidities and risk of frailty increase with age results in significant health and social care consumption. Increasing complexity amplifies fragmentation of care and results in sub optimal care outcomes. There is growing evidence base supporting effective service responses for older persons. These typically include multidisciplinary, community based teams providing services in or near to the older person’s home (the ‘what’). However, examples of systemic implementation are confined to smaller regions notably in Catalonia (Spain), Scotland and Singapore. This reflects the fact that the implementation of integrated care is problematic at scale. The need to attend to methods that support high autonomy professionals tasked with local implementation (the ‘who’) is a neglected area. This paper proposes a framework to implementing integrated care for older persons. In addition, it offers some initial empirical evidence that this approach has utility among managers and clinicians. In doing so seeks ...

Ghana country assessment report on ageing and health

Ghana, like many other countries, is experiencing a demographic transition with its ageing population. To provide reliable evidence for policy-making in ageing and health, this assessment report is prepared to identify priority issues on ageing in Ghana. By reviewing evidence from the WHO Study on global AGEing and adult health (SAGE) in Ghana and other sources, this document reveals the health status of older people in Ghana as well as the health systems response and policies relevant to ageing. The report also proposed 5 priorities relating to the prevention, treatment and care needs of older people in Ghana.

Integrated care for older people (ICOPE) implementation framework: guidance for systems and services

Alongside supporting community-level services, the Integrated Care for Older People (ICOPE) approach helps broader health and social care systems effectively respond to the diverse and complex needs of older people. The ICOPE Implementation Framework provides guidance for policy makers and programme managers to concretely assess and measure the capacity of services and systems to deliver integrated care at the community level.

The ICOPE Implementation Framework provides a score card to help assess the overall capacity of health and social care services and systems to deliver integrated care in community settings and support the development of ICOPE implementation action plans. There are 19 actions needed to implement ICOPE on the services level (meso) and systems level (macro). The scoring process provides an evidence-based means of highlighting areas for improvement as well as establishing concrete measures of future improvements.

The WHO Integrated Care for Older People (ICOPE)

The WHO Integrated Care for Older People (ICOPE) is a platform which will help facilitate learning and best practice sharing between countries around the world on ICOPE implementation. While this platform will also provide the opportunities for members to ask and help each other when they faced with the similar challenges.

The WHO ICOPE CoP will also act as a platform for sharing guidelines, toolkits and other resources released by WHO Department of Ageing and Life Course to support ICOPE implementation. Discussions on specific topics will be facilitated and responded by members from academic disciplines that include (but not limited to): epidemiology, psychology, medicine, nursing, dentistry as well as public health practitioners, researchers, policymakers, etc. The community will also facilitate the dissemination of key publications and resources.

The WHO ICOPE CoP will support the learning sharing in all level (macro, meso and micro level but will emphasize the discussion around ...

17th International Conference in Integrated Care "Building a platform for integrated care: delivering change that matters to people"

The 16th International Conference in Integrated Care "Building a platform for integrated care: delivering change that matters to people" will incorporate the 5th World Congress on Integrated Care as it comes to Europe for the first time. It will take place in Dublin, Ireland, from the 8-10 May 2017. 

The conference themes include: Promoting the health and welfare of people, families and communities; Timely transitions: optimizing patient flow across care settings: Preventing and managing chronic disease: engaging and empowering people; Ageing health and well being; and Implementing integrated care.

For more information, please visit: http://www.integratedcarefoundation.org/icic17 

Age UK’s Personalised Integrated Care Programme: where are we now?

Age UK launched its personalised integrated care programme in 2012 in Cornwall. In this post, published in its blog, some data about its evaluation are shown and discussed.

The main objectives of this programme are to improve health and wellbeing of older people by tailoring services to meet their needs, improve the experience and quality of care received, and to reduce unplanned hospital admissions amongst older people with multiple long-term conditions.

The evaluation showed a 31% reduction in all hospital admissions, a 26% reduction in emergency ones, and a 20% improvement in older people’s health and wellbeing. In addition, one fifth of aged people participating in the programme became volunteers in order to be able to improve other people’s health and wellbeing.

In 2015, this programme expanded to nine more places across the United Kingdom, a substantial challenge because, as it is said in the post, the needs ...

From integrated care towards DIY Health - Combining person-centered health care delivery, mobile technology and entrepreneurship

Introduction and objectives:

To achieve the level of impact necessary to reverse current trends of rising incidence and costs of multimorbidity and enabling healthy ageing will require new health care policy and practices. Notwithstanding integrated care receiving worldwide attention in improving healthcare delivery, the value of data driven and mobile technology for integration of health and care services remains unclear. Nevertheless, person-centered and data driven mobile health (mHealth) has the potential to evolve integrated care from business process re-design towards a new digital health ecosystem that is truly centered around a person facing health challenges. The objective of our study was to identify the opportunities and barriers of mHealth to do this.

Highlights:

MHealth applications attack the underlying causes of the multimorbidity and ageing challenge in various ways. First, mHealth lifestyle apps promise to help in the prevention of chronic disease and multimorbidity by attacking high risk conditions such as ...