IPCHS. Integrated People-Centred Health Services

Contents

Contents tagged: chronic care

June 10, 2020 Global Publication

Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts

Integrated care is a broad concept, used to describe a connected set of clinical, organizational, and policy changes aimed at improving service efficiency, patient experience, and outcomes. Despite examples of successful integrated care systems, evidence for consistent and reproducible benefits remains elusive. This review identified four perspectives on integrated care: patients’ perspectives, organizational strategies and policies, conceptual models, and theoretical and critical analysis.

Nov. 7, 2019 Africa Publication

Non-communicable diseases in sub-Saharan Africa: a scoping review of large cohort studies

Non-communicable diseases (NCDs) cause a large and growing burden of morbidity and mortality in sub-Saharan Africa. Prospective cohort studies are key to study multiple risk factors and chronic diseases and are crucial to our understanding of the burden, aetiology and prognosis of NCDs in SSA. The aim of this study was to identify the level of research output on NCDs and their risk factors collected by cohorts in SSA.

June 27, 2019 Global Publication

The impact of a comprehensive electronic patient portal on the health service use: an interrupted time-series analysis

EPPs hold promise for reducing hospital readmissions. Certain patient populations with chronic conditions may differentially benefit from portal use depending on their needs for communication with their providers.
However, there is little empirical research on the potential benefit that electronic patient portals (EPP) can have on the care quality and health outcomes of diverse multi-ethnic international populations. The purpose of this study is to determine the extent to which an EPP was associated with improvements in health service use.

Aug. 29, 2018 Europe Publication

The Core Dimensions of Integrated Care: A Literature Review to Support the Development of a Comprehensive Framework for Implementing Integrated Care

As part of the EU-funded Project INTEGRATE, the research sought to develop an evidence-based understanding of the key dimensions and items of integrated care associated with successful implementation across varying country contexts and relevant to different chronic and/or long-term conditions. This paper identifies the core dimensions of integrated care based on a review of previous literature on the topic

July 23, 2018 Europe Publication

Management of multimorbidity using a patient-centred care model: a pragmatic cluster-randomised trial of the 3D approach

The management of people with multiple chronic conditions challenges health-care systems designed around single conditions. There is international consensus that care for multimorbidity should be patient-centred, focus on quality of life, and promote self-management towards agreed goals. However, there is little evidence about the effectiveness of this approach. The article´s hypothesis was that the patient-centred, so-called 3D approach (based on dimensions of health, depression, and drugs) for patients with multimorbidity would improve their health-related quality of life, which is the ultimate aim of the 3D intervention.

July 23, 2018 Americas Publication

Patient-centred care for multimorbidity: an end in itself?

Multimorbidity, which is defined as living with two or more chronic health problems, is a major and growing problem, especially in societies with ageing populations and substantial socioeconomic disparities. It is associated with reduced quality of life, impaired functional status, poor physical and mental health, and increased mortality

July 18, 2018 Europe Publication

Barriers and Facilitators to Workforce Changes in Integrated Care

Health systems are faced with an ageing population and an increase in chronic conditions. These challenges require more appropriate approaches than the current largely single-disease and acute-care focussed health care systems. Integrated care is seen as one of the most promising of these approaches by targeting the health system, patient-provider relationships, care process design, communication infrastructures, community resources, and how care is delivered by health professionals. The aim of the study is to investigate the barriers and facilitators to the implementation of workforce changes implemented as part of integrated chronic care interventions.

March 25, 2018 Africa Publication

Integration of community home based care programmes within national primary health care revitalisation strategies in Ethiopia, Malawi, South-Africa and Zambia: a comparative assessment

In 2008, the WHO facilitated the primary health care (PHC) revitalisation agenda. The purpose was to stregthen African health systems in order to address communicable and non-communicable diseases. The aim of this article was to assess the position of civil society-led community home based care programmes (CHBC), which serve the needs of patients with HIV, within this agenda. It examined how their roles and place in health systems evolved, and the prospects for these programmes in national policies and strategies to revitalise PHC, as new health care demand arise. 

March 22, 2018 Global Publication

Individualising Chronic Care Management by Analysing Patients’ Needs – A Mixed Method Approach

Modern health systems are increasingly faced with the challenge to provide effective, affordable and accessible health care for people with chronic conditions. As evidence on the specific inmet needs and their impact on health outcomes is limited, practical research is needed to tailor chronic care to individual needs of patients with diabetes. Qualitative approaches to describe professional and informal caregiving will support understanding the complexity of chronic care. Results are intended to provide practical recommendations to be used for systematic implementation of sustainable chronic care models. 

Feb. 19, 2018 Western Pacific Publication

The Western Sydney Integrated Care Program (WSICP): Qualitative Evaluation

The ageing population together with an increasing prevalence of chronic conditions require a systems wide integrated approach to health care. This includes overcoming barriers between primary and secondary care, physical and mental health, and health and social care in order to provide patient centred care. In Australia, the New South Wales Ministry of Health is piloting an innovative Integrated Care Program in Western Sydney, foccussed on care facilitator roles to coordinate patient care between General Practices and hospitals. 

July 5, 2017 Global Publication

The SELFIE framework for integrated care for multi-morbidity: Development and description

The rise of multi-morbidity constitutes a serious challenge in health and social care organisation that requires a shift from disease-towards person-centred integrated care. The aim of the current study was to develop a conceptual framework that can aid the development, implementation, description, and evaluation of integrated care programmes for multi-morbidity. The framework structures relevant concepts in integrated care for multimorbidity and can be applied by different stakeholders to guide development, implementation, description, and evaluation. 

July 4, 2017 Africa Publication

Integration of community home based care programmes within national primary health care revitalisation strategies in Ethiopia, Malawi, South-Africa and Zambia: a comparative assessment

In 2008, the WHO facilitated the primary health care (PHC) revitalisation agenda. The purpose was to strengthen African health systems in order to address communicable and non-communicable diseases. The aim of this study was to assess the position of civil society-led community unity home based care programmes (CHBC), which serve the needs of patients with HIV, within this agenda. It examined how their roles and place in health systems evolved, and the prospects for these programmes in national policies and strategies to revitalise PHC, as new health care demands arise. 

May 26, 2016 Europe Publication

Developing care for a changing population: Supporting patients with costly, complex needs

Patients with multiple chronic conditions are a challenge for health care organization. In this report, it is offered a review of the most recent evidence regarding new models of care, and they are summarized in 10 points: (I) There are no specific ‘European’ answers to the problem of high cost/complexity, but a growing body of policy-relevant evidence is emerging, (II) Multifaceted interventions seem to work best for complex problems , (III) Identifying who is at risk of complexity is a crucial first step , (IV) The needs of patients identified as ‘complex’ are likely to vary considerably , (V) Good outcomes for complex patients need to be rooted in patient preferences and are likely to include non-medical goals, (VI) Interventions may not reduce high costs, at least in the short term, (VII) Chronic care models may not be fit for purpose for complex patients, (VIII) Although highly relevant, the implications for the ...

May 25, 2016 Europe Publication

Exploring payment schemes used to promote integrated chronic care in Europe

The rising burden of chronic conditions has led several European countries to reform healthcare payment schemes. This paper aimed to explore the adoption and success of payment schemes that promote integration of chronic care in European countries. A literature review was used to identify European countries that employed pay-for-coordination (PFC), pay-for-performance (PFP), and bundled payment schemes. Existing evidence from the literature was supplemented with fifteen interviews with chronic care experts in these countries to obtain detailed information regarding the payment schemes, facilitators and barriers to their implementation, and their perceived success.

Austria, France, England, the Netherlands, and Germany have implemented payment schemes that were specifically designed to promote the integration of chronic care. Prominent factors facilitating implementation included stakeholder cooperation, adequate financial incentives for stakeholders, and flexible task allocation among different care provider disciplines. Common barriers to implementation included misaligned incentives across stakeholders and gaming. The implemented payment schemes targeted ...

March 18, 2016 Americas, Global Publication

Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses

Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a “diagonal approach.” We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health ...

Jan. 4, 2016 Global Publication

Primary Care Physicians In Ten Countries Report Challenges Caring For Patients With Complex Health Needs

A compelling article that explores some of the current challenges facing the integration of primary care within the health systems of 10 high income countries. The data comes from the 18th annual Commonwealth Fund International Health Policy Survey of Primary Care Physicians which was completed in 2015 in Australia, Canada, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. While primary care physicians reported being well prepared for multiple chronic medical conditions, several health areas such as mental health and addiction were noted for being weak points for providers. A frequent challenge was a lack of communication with other parts of the health care system as well as with social services although there was significant variation between countries. An important finding of the study was “that having an electronic health record does not ensure electronic flow of information with doctors outside of one ...