“On the Margins and Not the Mainstream": Case Selection for the Implementation of Community based Primary Health Care in Canada and New Zealand

Healthcare system reforms are pushing beyond primary care to more holistic, integrated models of community based primary health care (CBPHC) to better meet the needs of the population. In order to scale up and spread successful models of care it is important to study what works and why. The first step is to select "appropiate" cases to study. In this commentary, this study reflect the difficulty in identifying "successful" models to study, the value of drawing on clinical and organisational networks and experts, and the association between policy context and ease of case selection. Such insights have important implications for ...

The Vanguard of Community-based Integrated Care in Japan: The Effect of a Rural Town on National Policy

Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community helahtcare resources for elderly people with chronic diseases and disabilities. This paper explains the establishment and outcomes of Japan´s first community-based integrated care system in the rural town because the history of Mitsugi could inform policy making in other countries with aging populations. 

Development, implementation and evaluation of a nurse led integrated, person-centred care with long term conditions

This proposal outlines a conceptual plan for innovative, integrated care designed for people living with long term condicions. This conceptual plan delivers a partnership between the health system, the person with long-term conditions (chornic), their family, and the community. The partnership aims to support people at home with access to effective treatment, consistent with the New Zealand Government Health Strategy. This concept of people-owned care is provided by nurses with advance practice skills, who co-ordinate care across services, locations and multiple long-term conditions. 

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. 

The theory and practice of integrative health care governance: the case of New Zealand´s alliances

The purpose of this paper is to outline the theory and practice of governance for integrated care, using the case of New Zealand´s healthcare alliances.

This paper argued that the new "experimental" governance models are needed for effective development of integrated care, illustrated through the example of alliance governance in New Zealand. While the alliances are in a relatively incipient state, they hold considerable promise when compared with the alternatives: corporate, democratic or clinical governance. Alliance governance provides for a different way of working, and for boldstering clinical leadership as central to this. 

Engaging Clinicians in Cocreating Health

The study aimed to determine how to engage clinicians in cocreating health by developing a framework for cocreating health to support the patient-clinician interaction and to identify the factors in its successful implementation in health services. The interaction between patients and clinicians is at the heart of health care. They are the first point of contact and a familiar interaction with the health service for most patients. Within UK health services there are three hundred million consultations held every year. Consultations happen in a variety of contexts, locations and with many different clinical professions. The overwhelming majority of these interactions ...

Diversity Conceptual Model for aged care: Person-centred and difference-oriented and connective with a focus on benefit, disadvantage and equity

AIM:

This project aimed to develop a Diversity Conceptual Model to support the aged care sector to identify diversity characteristics and associated benefits and disadvantages in order to consider greater equity in policy and practice.

METHODS:

A multi-method approach was used to develop the Diversity Conceptual Model using a literature review, organisation-wide consultation using a questionnaire, focus groups and interviews with key stakeholders.

RESULTS:

A Diversity Conceptual Model was developed as a visual 'tool', made up of numerous components, with a focus on diversity characteristics that may be creating benefits and disadvantages for a consumer to participate in their health ...

How High-Need Patients Experience the Health Care System in Nine Countries

In this study, high-need patients are defined as those aged 65 and older with at least three chronic conditions or a functional limitation in activities of daily living. The brief analyses data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults to investigate health care use, quality, and experiences among high-need patients in nine countries (Australia, Canada, France, Germany, the Netherlands, Norway, Sweden, Switzerland, and the United States) compared with other older adults. The study found that high-need adults use more health care – especially avoidable Emergency Department visits –, experience more cost-related barriers to care, and poorly coordinated ...

People-centred health care

In recent years, there has been increasing interest in the patient’s perspective of health care and how health systems can better respond to the needs of all health care stakeholders and constituencies in a holistic manner. Previous recommendations of Member States through the WHO Regional Committees for the Western Pacific and South-East Asia reflect the need to pursue work in the following: equity and fairness into policies; the development of programmes firmly grounded in ethical principles; the quality of health care and patient safety; human dignity, patients’ rights and needs, and the role of families, culture and society; the ...