JICA Special Issue: Integrated Palliative and End of Life Care for People with Advanced Dementia or Frailty

This special issue now seems uncannily prescient in view of the devastating impact of COVID-19 on people with advanced dementia or severe frailty, particularly in care homes.

The pandemic has heightened awareness of the possibility of a sudden and rapid transition from relative health to a palliative or end of life stage. This has opened up conversations about the potential burden from intensive treatments that are likely to be futile and the benefits of advance care planning.

The collection of papers in this special issue will be of interest to readers involved in planning, commissioning or delivering palliative and end ...

Integrating patient complexity into health policy: a conceptual framework

Clinicians across all health professions increasingly strive to add value to the care they deliver through the application of the central tenets of people-centred care (PCC), namely the ‘right care’, in the ‘right place’, at the ‘right time’ and ‘tailored to the needs of communities’.

This ideal is being hampered by a lack of a structured, evidence-based means to formulate policy and value the commissioning of services in an environment of increasing appreciation for the complex health needs of communities. This creates significant challenges for policy makers, commissioners and providers of health services. Communities face a complex intersection of challenges ...

Care Coordination for Vulnerable Families in the Sydney Local Health District: What Works for Whom, under What Circumstances, and Why?

 Healthy Homes and Neighbourhoods (HHAN), an integrated care programme in the Sydney Local Health District (SLHD), seeks to address the needs of disadvantaged families through care coordination, as one of its components. This research aims to determine for whom, when and why the care coordination component of HHAN works, and establish the reported outcomes for clients, service-providers and partner organisations.

Use of Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) for the screening of frailty and components of comprehensive geriatric assessment

Comprehensive geriatric assessment (CGA)—a key tool for geriatric medicine—is commonly used to assess older people’s health status and frailty. However, performing CGA in outpatient clinics is difficult because the assessment of cognition, activities of daily living (ADLs), depression, quality of life (QoL), nutrition, medications and social conditions is time consuming and requires the cooperation of medical staff. Frailty—an aspect of geriatric medicine that indicates the weakness of the body—is a critical measure of older adults’ physical function.

The Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) is a validated and simple ...

Patient Privacy and Integrated Care: The Multidisciplinary Health Care Team

This article explores legislative provisions in relation to patient privacy in the context of integrated health and social care and the development of multidisciplinary health care teams that include practitioners from private sector and government agencies in the health, education, child protection, family welfare, disability, aged-care, housing, local government and criminal justice sectors. 

mHealth for Integrated People-Centred Health Services in the Western Pacific: A Systematic Review

The global move towards achieving Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) requires a fundamental shift towards integrated healthcare systems. This vision of ‘Integrated care’ has been defined as a “coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment and collaboration within and between the cure and care sectors.”

Digital Health includes the use of mobile health (mHealth) applications, social media and health information systems and data. With the Internet of Things (IoT), it improves the data flow and interface between self-care, home-based services, primary ...

Refining Program Theory for a Place-Based Integrated Care Initiative in Sydney, Australia

A number of families living in our community experience many barriers to accessing health and social care. The problems that these families face are highly complex, often spanning over generations, and cannot be addressed by one agency alone.  The Healthy Homes and Neighbourhoods (HHAN) Integrated Care Initiative attempts to connect services to address these barriers, and ensure families have their complex health and social needs met; keep themselves and their children safe; and keep families connected to society.

This article shows that in addition to serving families in Sydney, HHAN has also established place-based initiatives (PBI) in disadvantaged areas such ...

A critical realist evaluation of an integrated care project for vulnerable families in Sydney, Australia

Healthy Homes and Neighbourhoods (HHAN) Integrated Care Initiative was established to improve the care of families with complex health and social needs who reside in Sydney Local Health District. HHAN seeks to provide long-term multi-disciplinary care coordination as well as enhance capacity building and promote integrated care. Findings of this study supported the initial programme theory that engagement and trust building with clients, alongside enhanced collaboration and integration of services, improved outcomes for vulnerable families with complex needs.

Understanding Young People and Their Care Providers’ Perceptions and Experiences of Integrated Care Within a Tertiary Paediatric Hospital Setting, Using Interpretive Phenomenological Analysis

Benefits of integrated care include improved health outcomes and more satisfaction with experiences of care for consumers. For children and young people with chronic and complex health conditions, their care may be fragmented due to the multitude of healthcare providers involved. This paper describes the experiences of integrated care in a paediatric tertiary hospital.

Integrated ambulatory care in the New Zealand health system: a scoping review

Integrated health systems, according to the World Health Organization (2017) are ''the organization and management of health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results and provide value for money.'' This is a very important concept in today's day and age, as access to healthcare has become a challenge and the population has never been sicker.

In New Zealand and internationally, emerging trends across health systems include a fundamental shift of care from hospitals to community-based settings and increased integration of services to better link ...