Integrated care in practice – the South Eastern Sydney experience

The purpose of this paper is to describe the recent efforts of a large publicly funded health care organisation in Sydney, Australia to implement integrated care (IC) "at scale and pace" in the messy, real-world context of a District Health Service. This paper highlights key factors relating to implementation and evaluation of a local IC Strategy in the real world. 

“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. 

Managing care integration during the implementation of large-scale reforms: the case of the Australian National Disability Insurance Scheme

The National Disability Insurance Scheme (NDIS) is a new program for the provision of support to people with disabilities in Australia. The purpose of this paper is to explore the early implementation experience of this scheme, with a particular focus on the implications of this scheme for issues of care integration. There is little empirical data relating to the implementation of the NDIS to date. This is the first study to explore boundary issues in relation to care integration. 

Integrated care in practice- the South Eastern Sydney Experience

The purpose of this paper is to describe the recent efforts of a large publicly funded healthcare organisation in sidney, Australia to implement the IC "at scale and pace" in the messy, real world context of a District Health Service. The paper outlines the theoretical and practical considerations used to design and develop a localised IC Strategy informed by the “House of Care” model (NHS England, 2016). The need for cross-agency partnership, a shared narrative, joint leadership and an IC Strategy underpinned by proven theoretical models model is described. This paper highlights key factors relating to implementation and evaluation of ...

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 ...

Consolidating the social health insurance schemes in China: towards an equitable and efficient health system

Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health ...