Contents tagged: health services

Feb. 1, 2017 Europe News

Progress on integrated care

This year´s conference of the International Foundation for Integrated Care (IFIC16) in Barcelona attracted over 1000 delegates and participants. Shortly afterwards, the World Health assembly adopted a global framework on integrated people-centred health services develope by the WHO, and an alliance of organisations created a European call for action to implement the framework at EU level. 

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Nov. 14, 2016 Europe Publication

Strengthening the model of primary health care in Estonia (2016)

Faced with increasing rates of chronic conditions, multi-morbidities and a growing elderly population, strengthening the primary health care model in Estonia is of critical importance. Moreover, recent health system reviews have signalled with clear consensus the importance of reviewing the organization of primary care to best respond to population and individual health needs.

In this context and backed by the available evidence, this assessment sets out to explore the organization of primary care looking to three key interrelated policy questions:

  1. How can a population approach be adopted, with consideration in particular to the existing health information system?
  2. What are the possible organizational models for primary care providers and settings that would match population needs? And further, how do these promote coordination with other services, such as services delivered in hospital and by social care? And,
  3. How do health system enabling factors support the transformation of health services delivery in terms ...

June 19, 2016 Americas Publication

The creative potential of health work to develop an integrated care model in Brazilian primary health care  

In November 2015, at the 3rd World Congress on Integrated Care and 8th National Congress of Integrated Medicine, “Co-producing High Quality People-Centered Integrated Care for ALL”, Debora Santos presented her PhD research on primary health care teams in Alagoas, the most unequal state in Brazil. According to Debora Santos, while Brazil's Unified Health System (SUS) is headed by principles of integrated care, in practice a biomedical conception of health typically prevails instead of one focused on integrated care. Therefore, the objective of her research was to identify potential ways to develop an integrated care model of primary health care focused on the principles of social health rights, integrated access, equity, team work and health promotion. Through focus groups and interviews with primary health care teams she identified several challenges and potentialities for integrated care. For example,  the teams faced both objective (clinical) and subjective (emotional) needs but had limited ...

May 24, 2016 Europe Publication

Presentation on the European Framework for Action on Integrated Health Services Delivery

This presentation from the WHO Regional Office for Europe sets out the four key domains of the European Framework for Action on Integrated Health Services Delivery: people, services, system and change. It was delivered during the 2-day final consultation of the Framework that took place in Copenhagen, Denmark on 2-3 May 2016. Over 170 participants debated the specificities of transforming health service delivery.

WHO/ Europe is developing the Framework for Action on Integrated Health Services Delivery for the European Region. The Framework’s goal is to support countries with policy options and recommendations that target key areas for strengthening the coordination/integration of health services.

The event marked the final step in the development of the Framework. The process was launched by the Regional Director in 2013 and has brought together leading experts in the field, and involved exchanges of background material, technical consultations and peer review of early drafts ...

May 24, 2016 Europe Publication

Step-by-step guide for developing integrated health services delivery profiles

This guide sets out to describe a structure and process for developing profiles on initiatives to transform health services delivery. It has been developed in line with the health system strengthening priorities of the WHO Regional Office for Europe, calling for integrated health services delivery as taken forward in the forthcoming Regional “Framework for Action on Integrated Health Services Delivery.” The guide has been prepared for those seeking to document a description of health services delivery transformations to share technical know-how and lessons learned. In doing so, it aims to contribute to the evidence-base on health services delivery transformations across the WHO European Region. The process of developing profiles is described according to five steps: defining the initiative; preparing the logistics; collecting the evidence; analysing the findings; and finalizing the profile.

May 24, 2016 Europe Publication

Health services delivery: a concept note

In order for health services delivery to accelerate gains in health outcomes it must continuously adapt and evolve according to the changing health landscape. At present, the case for change is a compelling one. However, despite mounting attention put to reforming health services delivery, there remains a persisting lack of consensus on its conceptualization. This paper aims to take stock of the developments in the literature on health services delivery and lessons from the firsthand experiences of countries, viewing clarity on the performance, processes and system dynamics of health services delivery a prerequisite for the rollout, scale-up and sustainability of reforms. Through a mixed-methods approach, evidence from existing frameworks and tools for measuring services delivery, country case examples and commissioned papers have been reviewed around three key questions: what are the outcomes of health services delivery? How can the health services delivery function be defined? And, how do other health ...

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 ...

Feb. 17, 2016 Americas Publication

Unintended costs of health care integration.

Decreasing -or, at least, containing- costs is one of the most important values usually attributed to health services integration. In this post published in the Harvard Medical School website, cost containing is questioned according to a paper published in JAMA Internal Medicine, where researchers describe how anual outpatient spending has grown in some integrated areas by 3.1 percentage point even when changes in use of outpatient care were minimal.

In this text, the author hypothesizes that integration between physicians and hospitals turn their position with insurers stronger, specially for prices of outpatient care. Health care integration may, in some situations, promote positions of power in the market, so that could have an influence in price negotiation and healthcare spending.

This unexpected cost increasing should be considered when designing integrated care policies and incentives, in order to avoid unintended spending cost that could threaten the sustainability of integrated health services.

June 1, 2015 Publication

The rising burden of diabetes and hypertension in southeast asian and african regions: need for effective strategies for prevention and control in primary health care settings.

Aim. To review the available literature on burden of diabetes mellitus (DM) and hypertension (HTN) and its coexistence in Southeast Asian (SEA) and the African (AFR) regions and to suggest strategies to improve DM and HTN prevention and control in primary health care (PHC) in the two regions. Methods. A systematic review of the papers published on DM, HTN, and prevention/control of chronic diseases in SEA and AFR regions between 1980 and December 2012 was included. Results. In the year 2011, SEA region had the second largest number of people with DM (71.4 million), while the AFR region had the smallest number (14.7 million). Screening studies identified high proportions (>50%) of individuals with previously undiagnosed HTN and DM in both of the SEA and AFR regions. Studies from both regions have shown that DM and HTN coexist in type 2 DM ranging from 20.6% in India ...