IPCHS. Integrated People-Centred Health Services

Contents

Contents tagged: integration

Nov. 9, 2020 Africa Publication

How well are non-communicable disease services being integrated into primary health care in Africa: A review of progress against World Health Organization’s African regional targets

In Africa, mortality due to NCDs is projected to overtake the combined mortality from communicable, maternal, neonatal, and nutritional diseases by 2030. To address this growing NCD burden, PHC systems will require substantial re-orientation. In this tudy published, researchers reviewed progress of African countries towards integrating essential NCD services into PHC. The study found that no country met all the recommended indicators to integrate NCD services into PHC, and seven countries met none of the indicators.

Nov. 9, 2020 Africa Publication

Adaptation and piloting of an integrated intervention model for alcohol use disorders in primary healthcare in rural Tanzania: a study protocol

According to Africa WHO, the African Region is faced with a growing burden of harmful alcohol consumption and its disastrous effects. There is no other consumer product as widely available as alcohol that accounts for as much premature death and disability. There are two main characteristics that describe alcohol consumption patterns in the Region: a high level of alcohol abstention in some countries and high volume consumption with severe health and social consequences in others. Alcohol use has immediate and long-term effects that increase the risks associated with numerous health conditions. Alcohol is a leading cause of risky sexual behaviours such as unprotected sex, sex with multiple partners, and produces an increased risk of sexual assault. These behaviours can result in unintended pregnancies and sexually transmitted infections (STIs) such as human papillomavirus (HPV) and HIV.

Integration of evidence-based interventions for alcohol use disorders (AUDs) into primary healthcare has potential to ...

Oct. 23, 2020 Western Pacific Publication

Health workforce planning under conditions of uncertainty: identifying supportive integrated care policies using scenario analysis

Integrated care presents health workforce planners with significant uncertainty. This results from:

  • (1) these workforces are likely in the future to be different from the present.
  • (2) integrated care's variable definitions.
  • (3) workforce policy and planning is not familiar with addressing such challenges.

One means to deal with uncertainty is scenario analysis. In this study shows some aspects of integration-supportive workforce governance and planning policies that were derived from the application of scenario analysis.Through a mixed methods design that applies content analysis, scenario construction and the policy Delphi method, it's analized a set of New Zealand's older persons health sector workforce scenarios. Developed from data gathered from workforce documents and studies, the scenarios were evaluated by a suitably qualified panel, and derived policy statements were assessed for desirability and feasibility.

Oct. 16, 2020

A reflection on the development of Integrated Health Services Networks in the Americas

In October 2009, the 49th Directing Council of the Pan American Health Organization (PAHO) approved the resolution “Integrated Networks of Health Services based on Primary Health Care” (IHSDN). The approval of this resolution formalized the commitment of the countries of the Americas to advance in the creation, development, and strengthening of IHSDNs in the Region, and constitutes until today a cooperation mandate for PAHO.

The resolution was accompanied by an important position paper called “Integrated Health Services Networks. Concepts, policy options and roadmap” published in May 2010. This document provided an action guide to implement the IHSDN, including a new definition of fourteen attributes grouped into four categories (care model, governance and strategy, organization and management, and allocation and incentives) to be met by integrated service networks. The importance of this is that the attributes offered leaders, managers, researchers, and those interested in general in this matter, a clear ...

Oct. 6, 2020 Global Publication

Effective implementation approaches for healthy ageing interventions for older people: A rapid review

Given the advanced demographic transition in the world, seeking healthy aging is an imperative task. In this review, strategies that favor a better quality of life for the elderly are shown, including the interaction of different levels of care (intra and extra system). All of this results in better global health indicators for the elderly population, which in turn translates into less need for care by the system.

Oct. 5, 2020 Africa Publication

Approaches to integrating palliative care into African health systems: a qualitative systematic review

Africa is characterized by a high burden of disease and health system deficits, with an overwhelming and increasing demand for palliative care (PC). Yet only one African country is currently considered to have advanced integration of palliative care into medical services and generalized PC is said to be available in only a handful of others. The integration of PC into all levels of a health system has been called for to increase access to PC and to strengthen health systems. Contextually appropriate evidence to guide integration is vital yet limited. This qualitative systematic review analyses interventions to integrate PC into African health systems to provide insight into the ‘how’ of PC integration. Forty articles were identified, describing 51 different interventions. This study found that a variety of integration models are being applied, with limited best practices being evaluated and repeated in other contexts. Interventions typically focused on integrating specialized PC ...

Sept. 30, 2020 Europe Publication

Integrated and patient-centred management of Parkinson’s disease: a network model for reshaping chronic neurological care

Chronic neurological diseases are the leading cause of disability globally. Yet, our health-care systems are not designed to meet the needs of many patients with chronic neurological conditions. Care is fragmented with poor interdisciplinary collaboration and lack of timely access to services and therapies. Furthermore, care is typically reactive, and complex problems are managed inadequately because of a scarcity of disease-specific expertise and insufficient use of nonpharmacological interventions. Treatment plans tend to focus on the disease rather than the individual living with it, and patients are often not involved in clinical decision making. By use of Parkinson’s disease as a model condition, this article show an integrated care concept with a patient-centred perspective that includes evidence-based solutions to improve healthcare delivery for people with chronic neurological conditions.

 

Aug. 25, 2020 South-East Asia Publication

COVID-19 care in India: the course to self-reliance

Many times we think of the integration of health systems as an urgent need. However, there are cases (and realities) where it is necessary to centralize to homogenize the action in the face of a crisis such as the SARS-CoV2 pandemic. The public health response to COVID-19 in India has been highly centralised, resulting in a homogenous strategy applied across a sixth of the world’s population.

Feb. 20, 2020 Europe Publication

Can Organisational Culture of Teams Be a Lever for Integrating Care? An Exploratory Study

Organisational culture is believed to be an important facilitator for better integrated care, yet how organisational culture impacts integrated care remains underspecified. In an exploratory study, we assessed the relationship between organisational culture in primary care centres as perceived by primary care teams and patient-perceived levels of integrated care

Jan. 13, 2020 Western Pacific Publication

Impact of integrated healthcare: Taiwan’s Family Doctor Plan

Integration of health services has been pursued worldwide. Diversity in integration approaches and in the contexts in which integrated programmes operate, however, hinders comparative analysis of care integration in both high-income countries (HICs) and low- and middle-income countries (LMICs). This study evaluates an HIC programme implemented in a delivery system resembling those of LMICs, especially its weak primary care system. 

Dec. 6, 2019 Americas Publication

The Generation of Integration: The Early Experience of Implementing Bundled Care in Ontario, Canada

By bundling services and encouraging interprofessional and interorganizational collaboration, integrated health care models counter fragmented health care delivery and rising system costs.
While research has been conducted on the facilitators and challenges of integration, there is less known about how integration is generated. This article explores the generation of integration through the dynamic interplay of contexts and mechanisms and of structures and subjects.

Nov. 29, 2019 Americas Event

NACIC2020 – 1st North American Conference on Integrated Care, Toronto, Canada

In light of the current COVID-19 pandemic and the travel restrictions in place, we regretfully inform you that the 1st North American Conference on Integrated Care in Toronto, scheduled for 5– 7  October 2020, cannot go ahead as planned. The conference has been postponed and rescheduled for 4– 6  October 2021. We are mindful of those working at the frontline and in the management of health and care systems right now and they must be our first priority. We are committed to delivering the conference and we appreciate your patience.

Nov. 6, 2019 Europe Publication

Integrated care systems in the English NHS: a critical view

The intriguing evolution of health policy in recent years has implications for all parts of the health system. With the UK falling behind most high-income countries on many measures of child health and growing evidence of a worrying health gap between UK children in deprived and affluent areas, paediatricians and others working in child health will want to remain abreast of the broader policy backdrop even where child health has not been privileged in policymaking. While the 2012 Health and Social Care Act reinforced the fragmentation of the service through multiple providers in competition with one another, subsequent policy promises local collaboration and joint working. This article traces this evolution and asks what it means.

Sept. 23, 2019 Americas Publication

Development and Testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey

This article discusses development and testing of the Provider and Staff Perceptions of Integrated Care Survey, a 21-item questionnaire, informed by Singer and colleagues’ seven-construct framework. Questionnaires were sent to 2,936 providers and staff at 100 federally qualified health centers and other safety net clinics in 10 Midwestern U.S. states. Item analyses, exploratory factor analysis, and confirmatory factor analysis were undertaken.

May 22, 2019 Americas Publication

Patient–Provider Video Telemedicine Integrated With Clinical Care: Patient Experiences

Real-time patient–provider video visits have the potential to engage patients by allowing them to access a clinical encounter without arranging transportation, taking time off from work, or spending time in a waiting room. Although millions of U.S. patients have used direct-to-consumer telemedicine services without in-person facilities, these services may lack integration with electronic health records and with clinicians from whom patients receive ongoing care. Evidence is limited from large-scale implementation of “house call” video visits integrated with ongoing health care delivery and providers in community primary care.

Feb. 12, 2019 Europe Publication

New models of home care

Policy-makers have outlined their ambitions to provide joined-up care closer to home and enable people to remain independent and in their own homes. Home care will be a central component of realising these ambitions. However, there are serious concerns about the state of the home care market
and the quality of care service users receive.
In this case, the present report summarises the evidence on innovations and models of home care that demonstrate potential in the following key opportunity areas:
1. Technology and digital
2. Co-ordinated care planning
3. Recruitment and retention
4. Autonomous team working
5. Alternative approaches to commissioning
6. Personalisation
7. Integrated care approaches
8. Community assets and connections
9. Family-based support and communal living
.

July 3, 2018 Africa Publication

From HIV prevention to non-communicable disease health promotion efforts in sub-Saharan Africa: A Narrative Review

Although HIV/NCD integration can improve effectiveness of preventive services at individual and community levels, potential public health impact of such approaches remain unknown as reach, adoptability, and sustainability of both integrated and nonintegrated NCD BCC approaches published to date have not been well characterized. So the aim of this study was to synthesize published literature on noncommunicable disease (NCD) behavior change communication (BCC) interventions in sub-Saharan Africa (SSA) among persons living with HIV (PLHIV) and in the general population to inform efforts to adopt similar HIV and NCD BCC intervention activities.

June 6, 2018 Western Pacific Publication

Coordinating Mental and Physical Health Care in Rural Australia: An Integrated Model for Primary Care Settings

The "GP Clinic" providers primary health care to people using community mental health services in a small town in Australia. This article examines the factors that have driven successful integration in this rural location. Integrated physical and mental health service models that focus on building local service provider relationships and are responsive to community needs and outcomes may be more beneficial in rural settings than top down approaches that focus on policies, formal structures, and governance. 

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. 

Feb. 19, 2018 Europe Publication

Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation

Many representations of the movement of healthcare knowledge through society exist, and multiple models for the translation of evidence into policy and practice have been articulated. Most are linear or cyclical and very few come dose to reflecting the dense and intricate relationships, systems and politicis of organizations and the processes required to enact sustainable improvements. This study illustrates how using complexity and network concepts can better inform knowledge translation (KT) and argue that changing the way we think and talk about KT could enhance the creation and movement of knowledge throughout those systems needing to develop and utilize it. 

Dec. 3, 2017 Global Publication

Integrated care: learning between high-income, and low- and middle-income country health systems

Integration is a challenging concept to define, in part because of its multiple dimensions and varied scope: from integrated clinical care for individual patients to broader systems integration- or linkage-involving wide range of interconnected services. This commentary compares integrated care in high-and lower- income countries. Although contexts may differ significantly between these settings, there are many common features of how integration has been understood and common challenges in its implementation

Aug. 8, 2017 Africa Publication

How to Integrate HIV and Sexual and Reproductive Health Services in Namibia, the Epako Clinic Case Study

During the past two decades, HIV and Sexual and Reproductive Health services in Namibia have been provided in silos, with high fragmentation. As a consequence of this, quality and efficiency of services in Primary Health Care has been compromised. 

The authors conducted an operational research (observational pre-post study) in a public health facility in Namibia. A health facility assessment was conducted before and after the integration of health services. A person-centred integrated model was implemented to integrate all health services provided at the health facility in addition to HIV and Sexual and Reproductive Health services. Comprehensive services are provided by each health worker to the same patients over time (longitudinality), on a daily basis (accessibility) and with a good external referral system (coordination). Prevalence rates of time flows and productivity were done. 

Results: Integrated services improved accessibility, stigma and quality of antenatal care services by improving the provider-patient communication, reducing ...

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. 

April 6, 2017 Western Pacific Publication

Experiencing integration: a qualitative pilot study of consumer and provider experiences of integrated primary health care in Australia

The terms integration and integrated care describe the complex, patient-centred strategies to improve coordination of healthcare services. Frameworks exist to conceptualise these terms, but these have been developed from a professional viewpoint. 

The objetive of this study was to explore consumers and provider´s concepts, expectations and experience of integrated care. A key focus was whether frameworks developed from a professional perspective are effective models to explore people´s experiences. 

March 30, 2017 Europe Publication

Integrating safety concepts in health and social care

Keeping individuals safe from harm and exploitation is a clearly articulated goal within both the health and social care sectors. Two key concepts associated with achieving this common aim are safety and safeguarding. The purpose of this paper is to critically appraise the differences in safety terminology used in health and social care, including opportunities and challenges for greater integration of safety systems across health and social care in England. 

Feb. 24, 2017 Western Pacific Publication

Managing care integration during the implementation of large-scale reforms: the case of the Australian National Disability Insurance Scheme

The National Disability Insurance Scheme (NDIS) is a new program for the provision of support to people with disabilities in Australia. The purpose of this paper is to explore the early implementation experience of this scheme, with a particular focus on the implications of this scheme for issues of care integration. There is little empirical data relating to the implementation of the NDIS to date. This is the first study to explore boundary issues in relation to care integration. 

Feb. 1, 2017 Global News

How can health and social care work together effectively?

Let´s consider what an integrated health and social care system might look like. Should the cultural differences between health and social care be preserved within a closer partnership? And what role can technology play in bringing together services that have traditionally worked in parallel? 

Read more

Oct. 3, 2016 Americas Publication

Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study

Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health.

There is a gap between health managers’ and professionals’ understanding of community-based primary mental health care. The integration of different processes of work entails both rethinking workforce actions and institutional support to help make changes.

 
 

Sept. 12, 2016 Europe Publication

Behavioural health consultants in integrated primary care teams: a model for future care

Significant challenges exist within primary care services in the United Kingdom (UK). These include meeting current demand, financial pressures, an aging population and an increase in multi-morbidity. Psychological services also struggle to meet waiting time targets and to ensure increased access to psychological therapies. Innovative ways of delivering effective primary care and psychological services are needed to improve health outcomes.

May 11, 2016 Global Publication

Report on the Global Knowledge Commons for Innovations in mHealth and eHealth

The International Society for Telemedicine & eHealth publishes (in an electronic form) the Report of the Innovation Working Group (IWG) Task Force on the Global Knowledge Commons for m-eHealth Innovations.

 

The report addresses the key challenge facing digital health, which is that of converting our collective knowledge into a global public good, accessible to all, thus enabling each actor in the ecosystem to benefit from what others know. The document postulates that a Global Knowledge Commons (GKC) for innovation in health or simply "the Commons", would be composed of three main constituents:

 

  • A database of projects, products and services;
  • A "Who is who in eHealth" - individual experts and institutions; and
  • Reusable m-eHealth knowledge objects, in various formats, such as articles, presentations, videos, etc.

 

The Commons would leverage existing repositories of the digital health space, and lead to five significant beneficial outcomes:

 

  • Digital intelligence at-a-glance through dash-boards by geography, application area and ...

March 18, 2016 Africa, Europe, Western Pacific, Global Publication

Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries

For most women in low and middle income countries (LMIC), antenatal care (ANC) plays a highly important dual role: not only does ANC provide effective interventions to reduce the risks associated with pregnancy and childbirth, it can also serve as a delivery platform for other health services. Particularly in settings where the prevalence of HIV/AIDS, sexually transmitted infections (STIs), tuberculosis (TB) and malaria is high, integrating services for these conditions with ANC can significantly expand their reach. In fact, the World Health Organization (WHO) identified integration of ANC with other health programmes as a key strategy for reducing missed opportunities for patient contact and improving maternal and child health (MCH). Evidence from the countries studied, however, suggests that in practice integrated delivery of ANC with other health services is not systematic or adequate and that opportunities for providing care for women are lost.

Several factors enable or hinder the ...