IPCHS

This growing repository holds WHO documents, scientific publications, policy documents, implementation reports, presentations and others with information and insights about integrated people-centred health services. Share your publication by clicking “Add publication”.

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May 25, 2016 Europe

Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Exploring payment schemes used to promote integrated chronic care in Europe

The rising burden of chronic conditions has led several European countries to reform healthcare payment schemes. This paper aimed to explore the adoption and success of payment schemes that promote integration of chronic care in European countries. A literature review was used to identify European countries that employed pay-for-coordination (PFC), pay-for-performance (PFP), and bundled payment schemes. Existing evidence from the literature was supplemented with fifteen interviews with chronic care experts in these countries to obtain detailed information regarding the payment schemes, facilitators and barriers to their implementation, and their perceived success.

Austria, France, England, the Netherlands, and Germany have implemented ...

May 25, 2016 Europe Global

Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

State humanitarian verticalism versus universal health coverage: a century of French international health assistance revisited

The French contribution to global public health over the past two centuries has been marked by a fundamental tension between two approaches: State-provided universal free health care and what we propose to call State humanitarian verticalism. Both approaches have historical roots in French colonialism and have led to successes and failures that continue until the present day. In this paper, the second in The Lancet's Series on France, we look at how this tension has evolved. During the French colonial period (1890s to 1950s), the Indigenous Medical Assistance structure was supposed to bring metropolitan France's model of universal ...

May 17, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors

Person-centered care - ready for prime time

Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that ...

May 17, 2016 Europe

Engaging and empowering people and communities, Strengthening governance and accountability, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Health-care improvements in a financially constrained environment

Although the European Council agreed on common values such as good quality, universally accessible care in 1996, those values are now under threat. Health expenditure in all European Union (EU) countries between 1996 and 2013 increased from 7·9% to 9·5% of gross domestic product. There is a need to adapt to a financially constrained environment.

WE CARE is an EU Seventh Framework Programme consortium tasked to propose a research and development roadmap for innovative, cost-contained, quality care. The roadmap should not only consider efficacy from clinical trials but also community effectiveness, including the appropriateness of services provided.

May 17, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Person-centred care after acute coronary syndrome, from hospital to primary care - A randomised controlled trial

Highlights

Person-centred care in the recovery after an acute coronary syndrome event,
Details of a co-created health plan to produce a partnership between patients and health care professionals,
The transition of care continuing the partnership from in-hospital care to primary care,
Improved self-efficacy by including a partnership compared to standard care alone.

Aim

To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome.

Method

199 patients with acute coronary syndrome < 75 years were randomly assigned to person-centred care intervention or treatment as usual and ...

May 17, 2016 Europe

Reorienting the model of care

Effects of Person-Centered Physical Therapy on Fatigue-Related Variables in Persons With Rheumatoid Arthritis: A Randomized Controlled Trial

Objective

To examine effects of person-centered physical therapy on fatigue and related variables in persons with rheumatoid arthritis (RA).

Interventions

The 12-week intervention, with 6-month follow-up, focused on partnership between participant and physical therapist and tailored health-enhancing physical activity and balancing life activities. The reference group continued with regular activities; both groups received usual health care.

Main Outcome Measures

Primary outcome was general fatigue (visual analog scale). Secondary outcomes included multidimensional fatigue (Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire) and fatigue-related variables (ie, disease, health, function).

Results

At posttest, general fatigue improved more in the intervention group than the reference group ...

April 27, 2016 Europe

Engaging and empowering people and communities, Creating an enabling environment

Circles of Support and personalization: Exploring the economic case

Circles of Support aim to enable people with learning disabilities (and others) to live full lives as part of their communities. As part of a wider study of the economic case for community capacity building conducted from 2012 to 2014, we conducted a mixed methods study of five Circles in North West England. Members of these Circles were supporting adults with moderate to profound learning disabilities and provided accounts of success in enabling the core member to live more independent lives with improved social care outcomes within cost envelopes that appeared to be less than more traditional types of support ...

April 26, 2016 Americas Europe Western Pacific

Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Integrating funds for health and social care: an evidence review

Objectives

Integrated funds for health and social care are one possible way of improving care for people with complex care requirements. If integrated funds facilitate coordinated care, this could support improvements in patient experience, and health and social care outcomes, reduce avoidable hospital admissions and delayed discharges, and so reduce costs. In this article, we examine whether this potential has been realized in practice.

Methods

We propose a framework based on agency theory for understanding the role that integrated funding can play in promoting coordinated care, and review the evidence to see whether the expected effects are realized in practice ...

March 18, 2016 Africa Europe Western Pacific Global

Reorienting the model of care, Coordinating services within and across sectors

Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries

For most women in low and middle income countries (LMIC), antenatal care (ANC) plays a highly important dual role: not only does ANC provide effective interventions to reduce the risks associated with pregnancy and childbirth, it can also serve as a delivery platform for other health services. Particularly in settings where the prevalence of HIV/AIDS, sexually transmitted infections (STIs), tuberculosis (TB) and malaria is high, integrating services for these conditions with ANC can significantly expand their reach. In fact, the World Health Organization (WHO) identified integration of ANC with other health programmes as a key strategy for reducing missed ...

Feb. 12, 2016 Americas Europe Western Pacific

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors

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 ...