Integrated Diabetes Care: A Multidisciplinary Approach

Integrated care is an approach that seeks to improve the quality of care for people with diabetes by ensuring that services are well coordinated around their needs. Healthcare professionals, people with diabetes and the system must be aligned to support improvement both in the delivery of care and in achieving better outcomes for people with diabetes.

Tenacious assumptions of person-centred care? Exploring tensions and variations in practice.

In recent decades, the ‘tenacious assumptions’ of biomedicine regarding the neutrality and universality of its knowledge claims have been significantly challenged by the growth of new collaborative and patient-focused models of Healthcare delivery. In this article, we discuss and critically reflect upon one such alternative Healthcare model developed at the University of Gothenburg Centre for Person-Centred Care in Sweden. This centre uses three clinical routines of narrative, partnership and documentation to provide Healthcare to people recognized as unique individuals rather than patients. Person-centred care in Gothenburg and more broadly is based on the assumption that a person is independently capable ...

Barriers and facilitators to the implementation of person-centred care in different healthcare contexts

Background

Primary care managers´perceptions of their capability in providing care planning with complex needs

The aim of this study is to investigate primary care managers´perceptions of their capability in providing care planning to patients with complex needs. Care planning is defined as a process where the patient, family and health professionals engage in dialogue about the patient´s care needs and plan care interventions together. 

Integrated Care: theory to practice

"Integrated care" is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team management is frequently the primary focus of integrated care when implemented internationally. This study examine the practical application of integrated care in the NHS in England to exemplify the prevalence of the case management focus. It looks at the evidence for effectiveness of multi-disciplinary team case management, for the focus on high-risk groups and for integrated care more generally. They suggest realistic expectations of what integration of care alone can achieve and additional research ...

Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators

With an ageing population there is a move towards the use of assisted living technologies (ALTs) to provide social care and health care services, and to improve service processes. These technologies are at the forefront of the integration of health and social care. However, economic evaluatios of ALTs, and indeed economic evaluations of any interventions providing both health benefits and benefits beyond health are complex. This paper considers the challenges faced by evaluators and presents a method of economic evaluation for use with interventions where traditional methods may not be suitable for informing funders and decision makers. They propose a ...

Community health center provider ability to identify, treat and account for the social determinants of health: a card study

The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20- million of America´s highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH.

The results suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and ...

Patient-Centered Care and People-Centered Health Systems in Sub-Saharan Africa: Why So Little of Something So Badly Needed?

Patient–centered care (PCC) is increasingly recognized as a key dimension of quality healthcare, but unfortunately remains poorly implemented in practice. This paper explores the current state of PCC in sub-Saharan Africa and potential barriers to its implementation, with a focus on public first line health services. They develop an analytical framework based on expert knowledge, field experience, and a conceptual literature review. Factors contributing to the (lack of) implementation of PCC are structured in three distinct but interacting layers. The first layer encompasses factors that influence and shape the performance of providers.  The training of health workers is key ...

Changes in Low-Value Services in Year 1 of the Medicare Pioneer Accountable Care Organization Program

Wasteful practices are widespread in the US health care system. It is unclear if payment models intended to improve health care efficiency, such as the Medicare accountable care organization (ACO) programs, discourage the provision of low-value services. So the objective in this study is to assess whether the first year of the Medicare Pioneer ACO program was associated with a reduction in use of low-value services. 

New care models. Emerging innovations in governance and organisational form

Because the vanguards have shown just how important is to build collaborative relationships between the organisations and leaders involved in developing new care models as well as the technical elements; This report looks at the different approaches being taken by MCP (multispecialty community provider) and PACS (primary and acute care system) vanguards to contracting, governance and other organisational infrastructure. It focuses on development at five sites: Dudley, Sandwell and West Birmingham, Salford; Northumberland; and South Somerset.