Patient and health-care provider experience of a person-centred, multidisciplinary, psychosocial support and harm reduction programme for patients with harmful use of alcohol and drug-resistant tuberculosis in Minsk, Belarus

Tuberculosis (TB) often concentrates in groups of people with complex health and social issues, including alcohol use disorders (AUD). Risk of TB, and poor TB treatment outcomes, are substantially elevated in people who have AUD. Médecins sans Frontières and the Belarus Ministry of Health have worked to improve treatment adherence in patients with multi-drug or rifampicin resistant (MDR/RR)-TB and harmful use of alcohol. In 2016, a person-centred, multidisciplinary, psychosocial support and harm reduction programme delivered by TB doctors, counsellors, psychiatrists, health-educators, and social workers was initiated. In 2020, we described patient and provider experiences within the ...

Commissioning [Integrated] Care in England: An Analysis of the Current Decision Context

The emergence of Integrated Care Systems (ICSs) across England poses an additional challenge and responsibility for local commissioners to accelerate the implementation of integrated care programmes and improve the overall efficiency across the system. To do this, ICS healthcare commissioners could learn from the experience of the former local commissioning structures and identify areas of improvement in the commissioning process. This study describes the investment decision process in integrated care amid the transition toward ICSs, highlights challenges, and provides recommendations to inform ICSs in their healthcare commissioning role.

Beyond the Point of No Return: A Discourse Analysis of Healthcare Professionals’ Perceptions of Digitally Supported Person-Centred, Integrated, and Proactive Care

Most countries are facing a common challenge: a rise in the number of chronically ill patients and limited medical resources. The combination of digital support and the principles of person-centred, integrated, and proactive care (Digi-PIP care) services constitutes the most ambitious initiative for patients with long-term needs. While there is research on digital support, person-centred, integrated, and proactive care, the combination of these components has been less explored.

The data set consisted of 29 qualitative interviews with healthcare professionals involved in four Nordic Digi-PIP care initiatives. Building on prevailing discourses on the modernisation of healthcare, we used discourse analysis to ...

A Systematic Review of Interventions that Use Multidisciplinary Team Meetings to Manage Multimorbidity in Primary Care

Multidisciplinary team (MDT) meetings could facilitate coordination of care for individuals living with multimorbidity, yet there is limited evidence on their effectiveness. We hence explored the common characteristics of MDT meetings in primary care and assessed the effectiveness of interventions that include such meetings, designed to improve outcomes for adults living with multimorbidity.

Integrating Health and Social Services in Finland: Regional Approaches and Governance Models

The study explores regional approaches to integrated care, focusing on regions with regular municipality-based and integrated unified health and social care administration. The aim is to describe a governance approach that supports care integration in the regions.

General practitioners' perceptions of distributed leadership in providing integrated care for elderly chronic multi-morbid patients: a qualitative study

Distributed Leadership (DL) has been suggested as being helpful when different health care professionals and patients need to work together across professional and organizational boundaries to provide integrated care (IC). This study explores whether General Practitioners (GPs) adopt leadership actions that transcend organizational boundaries to provide IC for patients and discusses whether the GPs’ leadership actions in collaboration with patients and health care professionals contribute to DL.

Transformations in the landscape of primary health care during COVID-19: Themes from the European region

The COVID-19 pandemic has dramatically impacted primary health care (PHC) across Europe. Since March 2020, the COVID-19 Health System Response Monitor (HSRM) has documented country-level responses using a structured template distributed to country experts. We extracted all PHC-relevant data from the HSRM and iteratively developed an analysis framework examining the models of PHC delivery employed by PHC providers in response to the pandemic, as well as the government enablers supporting these models. Despite the heterogenous PHC structures and capacities across European countries, we identified three prevalent models of PHC delivery employed: (1) multi-disciplinary primary care teams coordinating with public health ...

The principles of person-centredness in quality patient care-Evaluation of the Community Pharmacy Services Quality Guidelines in Estonia

Person-centredness is considered a key component of quality healthcare and the core competence of all healthcare professionals. However, person-centred care (PCC) is not often considered a priority for improving the quality of healthcare. This study aimed to evaluate to what extent the PCC principles are included in the Community Pharmacy Services Quality Guidelines (CPSQG) in Estonia.

Importance of work engagement in primary healthcare

Work engagement is crucial for quality care at the primary healthcare level. This is especially true during the Covid-19 pandemic, as it has effects on the community from both a health and economic point of view. For example, inadequate work engagement can lead to fewer referrals to the secondary healthcare level. This study aims to examine the work engagement level in a public healthcare organisation at the primary healthcare level to further explore the role of work environment characteristics. The study addresses a research gap in the field of primary healthcare and emphasises the importance of managing the factors promoting ...

Resilience of the primary health care system – German primary care practitioners’ perspectives during the early COVID-19 pandemic

Primary care is a relevant pillar in managing not only individual, but also societal medical crises. The COVID-19 pandemic has demanded a rapid response from primary care with interventions in the health care system. The aim of this paper was to explore the responses of primary care practitioners (PCP) during the early COVID-19 pandemic and to analyze these with a view on the resilience of the primary health care system from the PCPs perspective.