IPCHS. Integrated People-Centred Health Services


Learn from real-life experiences with health services reform. We distinguish three types: emerging, promising and leading practices. Share your practice by clicking "Add practice".

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Sept. 7, 2016 Europe

Strengthening diabetes service delivery at the primary care level in Iceland

Problem: Rising prevalence of type 2 diabetes; diabetes care delivery concentrated in higher-level care settings; increasing waiting times for diabetes services; geographic inequities in access to diabetes-related care.

Solution highlights: Following grassroots efforts to increase the role of primary care providers in managing patients with diabetes, formal clinical guidelines to support diabetes care delivery at the primary level were published in 2009. The delivery of diabetes-related care in primary settings is increasing as a result; knowledge gained through experiences working abroad provided inspiration for the initiative and fostered local innovation; informal discussions among providers had sufficient power to initially motivate ...

Sept. 7, 2016 Europe

Community support programmes for people affected by dementia in Athens, Greece

Problem: Ageing population with increasing prevalence of dementia; limited scope of services available for patients with dementia and needs of informal caregivers largely unrecognized; inadequate resources made available for dementia-related care.

Solution highlights: The nonprofit organization AAADRD opened four day care centres across Athens to directly provide support services to people affected by dementia. The organization also campaigned extensively to gain attention for their cause and pushed the government to develop a national dementia action plan; highly motivated actors directly affected by dementia or working in related fields played an important role in identifying and understanding service delivery gaps; as ...

Sept. 6, 2016 Europe

Defining and standardizing primary care in Georgia

Problem: Ageing population with a rising burden of chronicity; lack of coverage for basic health services and high out-of-pocket costs for patients; low productivity resulting from an overabundance of physicians; weak gatekeeping ability of primary care.

Solution highlights: Government reforms aiming to establish universal health care, increase state involvement in the health system and strengthen regulation have been introduced; articulating a clear government vision ensured a strong foundation on which to build reforms; learning from previous experiences and seeking expertise from international partners helped the initiative avoid potential difficulties; inclusion of stakeholders in the design process helped build local consensus ...

Sept. 6, 2016 Europe

Advancing the role of nurses in Finland to improve patients’ access to care

Problem: Shortage of physicians, particularly in rural areas; high volume of nurses compared to the WHO European Regional average; limited autonomy and scope of practice for nurses.

Solution highlights: The Ministry of Social Affairs and Health promoted the shift of responsibilities from physicians to nurses through implementing supportive policies, legislation and incentives; partnerships and international networks facilitated information exchanges and offered inspiration for activities during the initiative’s design; national legislation provided the necessary framework for aligning changes in the professional scope of practice for nurses; the development of postgraduate advanced nursing programmes in partnership with universities supported the sustainability ...

Sept. 6, 2016 Europe

Telerehabilitation for patients with chronic obstructive pulmonary disease (COPD) in Denmark

Problem: Significant burden of COPD on health system resources; limited capacity of patients to self-manage COPD symptoms leading to deterioration in their condition and frequent hospital readmissions; weak continuity of care for COPD patients resulting from incompatible electronic medical record systems and fragmentation of providers.

Solution highlights: A pilot programme to test home-based telerehabilitation for COPD patients was designed and implemented by researchers at Aalborg University; a supportive political and legislative environment provided a platform for furthering the development of e-health and telemedicine; partnerships with stakeholders outside the health sector supported the development of telemedicine and helped drive service delivery ...

Sept. 6, 2016 Europe

Implementing targeted cancer screening programmes in the Czech Republic

Problem: Weak uptake of available cancer screenings; late detection of cancer; high cancer mortality rates.

Solution highlights: The Ministry of Health developed a national cancer screening programme to increase population uptake of existing screening services. Through this programme, health insurance companies proactively send at-risk enrolees personalized invitations to participate in cancer screenings; strong Ministerial leadership provided an overarching direction for the initiative, promoting alignment across key stakeholders; use of available data helped identify key problems and supported tailoring of activities to meet observed gaps in service delivery; national information campaigns, run through various media channels, supported efforts by educating the ...

Sept. 6, 2016 Europe

Developing an integrated e-health system in Croatia to drive care improvements

Problem: Rising burden of chronic disease; lack of standardization in care quality; disparities in access to health services; concentration of care in higher-level settings; inefficiencies in service delivery due to misaligned incentives and a lack of monitoring.

Solution highlights: An electronic Central Health Information System (CEZIH) was introduced by the government to connect stakeholders and provide real-time data on patients and providers; a strong government commitment and top-down leadership established the necessary conditions for the widespread adoption of e-health; data collected through the e-health system helped drive performance improvements; a new payment model for primary care providers was introduced and ...

Sept. 6, 2016 Europe

Introducing home care services in Bulgaria

Problem: Ageing population, with nearly a fifth over age 65 in 2011; high and rising prevalence of chronic disease, comorbidities and disabilities; scope of services too narrow to adequately manage the full range of health and social care needs; expensive institutional and specialized services overused.

Solution highlights: The introduction of home care services was proposed as a patient-oriented solution for ensuring appropriate service provision closer to home; a pilot approach allowed the gradual rollout and testing of an existing home care model being implemented abroad, which was adapted to meet the Bulgarian context; efforts to introduce home care included creating ...

Sept. 6, 2016 Europe

Shifting towards community-oriented mental health care in Belgium

Problem: High burden of disease from mental health conditions. Heavy reliance on institutionalization in mental health care provision; limited availability of community mental health services.

Solution highlights: Changes to legislation, policy and care guidelines at the national level guided mental health reform and government funding was made available to promote the implementation of local community mental health projects aligned with the new national vision for mental health; top-down support for bottom-up ideas ensured both the necessary resources and local ownership needed to optimize mental health reform; a supportive legislative framework helped solidify a common vision for mental health reform, providing ...

Sept. 6, 2016 Europe

Strengthening prenatal and obstetric care in Belarus

Problem: High rates of maternal and infant mortality; inadequate provision of prenatal care and high rates of unattended births; weak capacity for delivery of prenatal and obstetric services in appropriate care settings; geographic disparities in access to prenatal and obstetric services.

Solution highlights: Improving maternal and child health was established as a key government priority. Strong top-down support for change reinforced by legislation provided a guiding framework for transformations; Investigation into key challenges leading to a strong understanding of root causes ensured health reforms responded to needs; prenatal screening recommendations were developed and changes to resource distribution, provider training and ...