Self-management support for chronic disease in primary care: frequency of patient self-management problems and patient reported priorities, and alignment with ultimate behavior goal selection

To enable delivery of high quality patient-centered care, as well as to allow primary care health systems to allocate appropriate resources that align with patients’ identified self-management problems (SM-Problems) and priorities (SM-Priorities), a practical, systematic method for assessing self-management needs and priorities is needed. In this current report, are present the patient reported data generated from Connection to Health (CTH), to identify the frequency of patients’ reported SM-Problems and SM-Priorities; and examine the degree of alignment between patient SM-Priorities and the ultimate Patient-Healthcare team member selected Behavioral Goal.

Impact of health care reform on enrolment of immigrants in primary care in Ontario, Canada

Health is driven by the conditions in which people live and work. Immigrant populations face many challenges and disruptions in living conditions during their settlement process, including the loss of regular health services. Establishing a direct relationship with a family physician is an important aspect of the settlement process for immigrant populations

In 2003, Ontario introduced a patient enrolment system as part of health care reforms, aimed at enhancing primary health care services, but it is unclear whether immigrants have benefited from this health care reform. Therefore, this article studied whether this reform changed the extent of immigrants’ enrolment in ...

Globalization and health equity: The impact of structural adjustment programs on developing countries

Among the many drivers of health inequities, this article focuses on important, yet insufficiently understood, international-level determinants: economic globalization and the organizations that spread market-oriented policies to the developing world. One such organization is the International Monetary Fund (IMF), which provides financial assistance to countries in economic trouble in exchange for policy reforms. Through its ‘structural adjustment programs,’ countries around the world have liberalized and deregulated their economies. We examine how policy reforms prescribed in structural adjustment programs explain variation in health equity between nations—approximated by health system access and neonatal mortality. Our empirical analysis uses an original dataset ...

Health in the 2030 Agenda for Sustainable Development: from framework to action, transforming challenges into opportunities

The clock is ticking and just a little more than 10 years remain to meet the 17 Sustainable Development Goals (SDGs). Enhanced political and public awareness, inter- and transdisciplinary engagement, new partnerships, and multisectoral collaborations are required to foster knowledge-and-action societies in order to tackle the complex issues that are inherent to sustainable development. A one-day symposium held in Basel, Switzerland, in November 2018 offered a venue for open exchange on how to stimulate dialogue for co-creating innovative ideas and scalable action to address some of the most pressing challenges of the 2030 Agenda for Sustainable Development.

Clinical leadership and integrated primary care: A systematic literature review

As numbers of chronically ill patients with complex healthcare needs are increasing, primary care professionals will be challenged to deliver integrated care. Integrated care is about ‘delivering seamless care for patients with complex long-term problems cutting across multiple services, providers and settings.
Leaders are needed to address healthcare changes essential for implementation of integrated primary care. What kind of leadership this needs, which professionals should fulfil this role and how these leaders can be supported remains unclear.

Using the Project INTEGRATE Framework in Practice in Central Coast, Australia

Integrated care implies sustained change in complex systems and progress is not always linear or easy to assess. The Central Coast integrated Care Program (CCICP) was planned as a ten-year place-based system change. This paper reports the first formative evaluation to provide a detailed description of the implementation of the CCICP, after two years of activity, and the current progress towards integrated care.

Challenges to patient centredness – a comparison of patient and doctor experiences from primary care

Many countries and international organisations, such as OECD and WHO, have chosen patient centredness as the approach to ensure that the patients’ needs, values, and preferences are appropriately considered in the health care meetings. Whereas most OECD countries show progress in implementing patient-centred care, no country performs in the top group on all indicators in cross-country comparison. Patient-centred consultation methodologies vary, but reoccurring components can be identified in the literature, such as the patient’s narrative and collaboration.
This article designed an observational study to investigate the level of patients’ and doctors’ ratings of patient-centred aspects of the primary care ...

The impact of a comprehensive electronic patient portal on the health service use: an interrupted time-series analysis

EPPs hold promise for reducing hospital readmissions. Certain patient populations with chronic conditions may differentially benefit from portal use depending on their needs for communication with their providers.
However, there is little empirical research on the potential benefit that electronic patient portals (EPP) can have on the care quality and health outcomes of diverse multi-ethnic international populations. The purpose of this study is to determine the extent to which an EPP was associated with improvements in health service use.

Implications of interprofessional primary care team characteristics for health services and patient health outcomes: A systematic review with narrative synthesis

Interprofessional primary care (IPPC) teams are promoted as an alternative to single profession physician practices in primary care with focus on preventive care and chronic disease management. Characteristics of teams can have an impact on their performance.

Literature focused on the implications of team characteristics on team processes, such as teamwork, collaboration, or satisfaction of patients or providers. Despite heterogeneity of contexts, some trends are observable: shared space, common vision and goals, clear definitions of roles, and leadership as important to good teamwork. The impacts of these on health care outputs or patient health are not clear. So, this systematic ...

Shared Decision Making to Improve Care and Reduce Costs

Asleeper provision of the Affordable Care Act (ACA) encourages greater use of shared decision making in health care. For many health situations in which there's not one clearly superior course of treatment, shared decision making can ensure that medical care better aligns with patients' preferences and values. Shared decision making has the potential to provide numerous benefits for patients, clinicians, and the health care system, including increased patient knowledge, less anxiety over the care process, improved health outcomes, reductions in unwarranted variation in care and costs, and greater alignment of care with patients' values.