Physician Assistants and Nurse Practitioners in Primary Care Plus: A Systematic Review

Shifting specialist care from the hospital to primary care/community care (also called primary care plus) is proposed as one option to reduce the increasing healthcare costs, improve quality of care and accessibility.

The aim of this systematic review was to get insight in primary care plus provided by physician assistants or nurse practitioners.

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 ...

State of Commitment to Universal Health Coverage

The State of commitment to universal health coverage (UHC) provides a multi-stakeholder consolidated view on the state of progress being made towards UHC at country and global levels.

The review is political, country-focused and action-oriented in nature and complements the more technical and global UHC monitoring report focusing on UHC indicators on service coverage and financial protection.

The State of UHC Commitment  follows the UHC Political Declaration’s Key Targets, Commitments and Follow-up Actions and support national accountability and advocacy processes to ensure political leaders are held accountable for their UHC commitments.

The synthesis report summarises the state of UHC ...

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 ...

Indicators of an Integrated Home Care Model Shaped by the Needs of Patients Discharged from the Emergency Department

Developing community care models aims to satisfy the needs of patients’ in-home care comprehensively. This is crucial to decrease adverse events and prevent rehospitalization.

The growing burden of chronic diseases, patients experiencing fragmented care, and increasing demand for coordination across providers in the health and social sector correlates with the need for the integration of care. The starting point in developing an integrated care strategy should be identifying and assessing population needs.

Models of integrated care may enhance patient satisfaction, increase the perceived quality of care, and enable access to services. The term ‘new models of care’ refers to a ...

Achieving patient priorities: an alternative to patient-reported outcome measures (PROMs) for promoting patient-centred care

For the past two decades, patient-centredness has served as one of six acknowledged dimensions of healthcare quality. Initially, healthcare institutions described patient centredness superficially—clean waiting rooms, hotel-like bed and board, access to innovative medical technology—and measured it with crude satisfaction scales. The concept of patient-centred care evolved into a model attuned to the patient experience of care, defined by the interactions between patients and providers and the care environment.This patient experience model of patient-centred care has deep normative roots around principles of the patient as the locus of control and a demand for individualisation and customisation of ...

Integrated Care and Geriatrics: A Call to Renovation from the COVID-19 Pandemic

We are experiencing an unprecedented demographic change, in terms of speed. The population over 65 years of age corresponds to approximately 9% of the world population (Population Division of the Department of Economics and Social Affairs of the United Nations).
We know that the elderly population has a high risk of suffering from serious diseases.

Long-term care facilities (LTCFs) of geriatric care has been traditionally marginalized within healthcare networks. LTCFs have constantly been living in the ambiguity that their residential nature does not fit with the relevant clinical burden of care of their frail and complex residents.

Covid 19 presents ...

Leadership in integrated care networks: A literature review and opportunities for future research

This article reviews research on leadership in integrated care networks. It is timely as scholars and policy makers regard integrated care as a key part in reforming healthcare systems to cope with demographic aging, the rising prevalence of chronic diseases and the growing demand for long-term care.

In many countries, elderly patients with chronic conditions require a web of services delivered by several providers collaborating in inter-organisational networks. In view of their global importance, it is surprising how little we know how these networks are led. Like traditional organisations, networks require leadership to function effectively. This paper reviews central characteristics ...

Primary health care, the Declaration of Astana and COVID-19

Abstract Four decades after the Declaration of Alma-Ata, its vision of health for all and strategy of primary health care are still an inspiration to many people. In this article we evaluate the current status of primary health care in the era of the Declaration of Astana, the sustainable development goals, universal health coverage and the coronavirus disease 2019 pandemic.

Communities, universal health coverage and primary health care

Universal health coverage (UHC) depends on a strong primary health-care system. To be successful, primary health care must be expanded at community and household levels as much of the world’s population still lacks access to health facilities for basic services. Abundant evidence shows that community-based interventions are effective for improving health-care utilization and outcomes when integrated with facility-based services. Community involvement is the cornerstone of local, equitable and integrated primary health care.