As longevity increases, individuals with chronic, life-limiting conditions will live longer with disease burden and functional decline. Nurse practitioners can integrate symptom management, early decision-making, and supportive care into the primary care setting to improve quality of life and decrease economic and emotional impact at the end of life.
The United Nations Convention on the Rights of the Child (to which all european Union (EU) and European Economic Area (EEA) Member States are signatories) defines the highest attainable standard of healthcare as a fundamental right of every child. This study is embedded in the various peculiarities of national healthcare systems and the ethical and legal concerns bound to the sharing of child health data, being his aim to report on the development of surveys to explore integration of care for children living with complex needs across the European Union (EU) and European Economic Area (EEA)
Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The experience of colonisation, and the long-term effects of being colonised, has caused inequalities in Indigenous health status, including physical, social, emotional, and mental health and wellbeing. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models.
As the national rhetoric focuses on supporting the delivery of population health and integrated care, different models of care and new ways of working are being implemented across England. While integrated care systems (ICSs) are emerging to lead on planning and commissioning care for their populations, providers are also working together to deliver integrated care locally.
The NHS has been challenged to adopt new integrated models of service delivery that are tailored to local populations. Evidence from the international literature is needed to support the development and implementation of these new models of care. So, the aim of this study aimed to carry out a systematic review of international evidence to enhance understanding of the mechanisms whereby new models of service delivery have an impact on health-care outcomes
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
7. Integrated care approaches
8. Community assets and connections
9. Family-based support and communal living
Patient-centred care (PCC) is one of the six dimensions of healthcare and was formally described by the Institute of Medicine in 2001 as healthcare that respects and responds to the preferences, needs and values of the individual patients throughout all healthcare decisions. PCC is an approach that has become central to policies and programming to improve healthcare efficiencies and address patient safety issues.
In that sense, The shift to the patient-centred care (PCC) model as a healthcare delivery paradigm calls for systematic measurement and evaluation. In an attempt to develop patient-centred quality indicators (PC-QIs), this study aimed to identify quality indicators that can be used to measure PCC
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.
Models of integrated care continue to evolve globally with the goal to deliver more integrated people-centred health services. These models are characterized by innovative collaborations and partnerships across sectors. One enduring question relates to the best governance structures for these complex, multi-player systems and networks. Governance encompasses all aspects of managing health services delivery to support health system goals, including financing, human resources, and technology, and it is a critical instrument to strengthen public and institutional performance.
The current pandemic is a good reminder that circumstances and environments strongly influence health and well-being. It emphasizes the need to focus on whole-systems health, which cuts across political, economic, and social landscapes. Whole-system health requires governance that is agile and can respond quickly to emerging changes to manage the complex interdependent partnerships in integrated health systems. It further points to the need for diffusion of governance from a state/health services centred ...
To encourage clinical and financial efficiency, the Canadian province of Ontario initiated an integrated care program – Integrated Funding Models (IFMs) that required collaboration and coordination across acute and post-acute care sectors. This research shows how program implementers went beyond policy-makers’ original designs, to make integrated care sustainable for chronic diseases.
In Australia and internationally there is a strong policy commitment to the redesign of health services toward integrated physical and mental health care. When executed well, integrated care has been demonstrated to improve the access to, clinical outcomes from, and quality of care while reducing overtreatment and duplication. Despite the demonstrated effectiveness and promise of integrated care, exactly how integrated care is best achieved remains less clear. The aim of this review study was to identify factors that support the implementation of integrated care between physical and mental health services. An integrative review was conducted following the framework developed by Whittemore and Knafl, with quantitative and qualitative evidence systematically considered. To identify studies, Medline, PubMed, PsychINFO, CINAHL were searched for the period from 2003 to 2018, and reference lists of included studies and review articles were examined. Nineteen studies were included. Synthesis of study findings identified seven key factors supporting ...
Recent decades have witnessed increases in (a) integrated physical and behavioral health services and (b) the treatment of opioid use disorders (OUD) in primary care settings – also known as office-based opioid treatments (OBOT) – using a combination of medication and psychosocial support. Providing these services requires a workforce trained to address addiction’s psychosocial components and interventions addressing addiction’s biological and neurological mechanisms. This paper examines the implementation factors, clinic workflow and roles, and administrative considerations of two models of integrated care in order to identify ways of increasing treatment capacity and expanding OUD treatment uptake in integrated primary care settings.
Ministers of Health of the Region of the Americas agreed on a new policy to address the fragmentation of health systems, a problem that affects the organization, management, and delivery of care in almost the entire Region. The Policy on Integrated Care for Improved Health Outcomes was adopted by the 30th Pan American Sanitary Conference of the Pan American Health Organization (PAHO), which meets this week in Washington, DC.
A sustainable NHS requires a shift from reactive acute care to proactive ambulatory care, from secondary care to primary care, with a focus on health creation by empowering people and communities. This will require evaluation of transformed models of care to create a new evidence base, which in turn requires a strong primary care research delivery infrastructure.