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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Sept. 19, 2016 Americas

Engaging and empowering people and communities, Creating an enabling environment

Evolving Concepts of Patient-Centered Care and the Assessment of Patient Care Experiences: Optimism and Opposition

This article summarise, a personal view of the author (Paul D. Cleary dean of the Yale School of Public Health), on the available research, concerning measurement of “patient satisfaction” and “patient care experience”. Author argues that patient experiences measurement efforts are being devoted to providing high-quality patient-centered care. Some indicators and surveys are discussed in terms of their reliability, validity and correlation across individuals and settings with other quality indicators.

Special attention is paid to the Consumer Assessment of Healthcare Providers and Systems (CAHPS), launched in 1995 by the Agency for Healthcare Research and Quality (AHRQ). The CAHPS surveys are ...

Sept. 15, 2016 Europe Global

Strengthening governance and accountability

Power and Integrated Health Care: Shifting from Governance to Governmentality

Integrated care occurs within micro, meso and macro levels of governance structures, which are shaped by complex power dynamics. Yet theoretically-led notions of power, and scrutiny of its meanings and its functioning, are neglected in the literature on integrated care. We explore an alternative approach. Following a discussion on governance, two streams of theorising power are presented: mainstream and second-stream. Mainstream concepts are based on the notion of power-as-capacity, of one agent having the capacity to influence another—so the overall idea is ‘power over ’. Studies on integrated care typically employ mainstream ideas, which yield rather limited analyses. Second-stream concepts ...

Sept. 12, 2016 Europe

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

Elaboration of the Gothenburg model of person-centred care

OBJECTIVE:

In this paper, it is aimed to explore professionals understanding of PCC routines as they implement the GPCC model in a range of different settings.

METHODS:

It is conducted a qualitative study and interviewed 18 clinician-researchers from five health-care professions who were working in seven diverse GPCC projects.

RESULTS:

Interviewees accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships.

CONCLUSION:

This study illustrates what is needed for health-care professionals to implement PCC ...

Sept. 12, 2016 Americas

Engaging and empowering people and communities, Reorienting the model of care, Creating an enabling environment

Promoting Policy, Systems, and Environment Change to Prevent Chronic Disease: Lessons Learned From the King County Communities Putting Prevention to Work Initiative.

Initiatives that convene community stakeholders to implement policy, systems, environment, and infrastructure (PSEI) change have become a standard approach for promoting community health. To assess the PSEI changes brought about by the King County, Washington, Communities Putting Prevention to Work initiative and describe how initiative structures and processes contributed to making changes.

Sept. 12, 2016 Americas

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

Effect of care management program structure on implementation: a normalization process theory analysis

Care management in primary care can be effective in helping patients with chronic disease improve their health status, however, primary care practices are often challenged with implementation. Further, there are different ways to structure care management that may make implementation more or less successful. Normalization process theory (NPT) provides a means of understanding how a new complex intervention can become routine (normalized) in practice. In this study, we used NPT to understand how care management structure affected how well care management became routine in practice.

Sept. 12, 2016 Africa

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

Health policy and integrated mental health care in the SADC region: strategic clarification using the Rainbow Model

Mental illness is a well-known challenge to global development, particularly in low-to-middle income countries. A key health systems response to mental illness is different models of integrated health care, especially popular in the South African Development Community (SADC) region. This complex construct is often not well-defined in health policy, hampering implementation efforts. A key development in this vein has been the Rainbow Model of integrated care, a comprehensive framework and taxonomy of integrated care based on the integrative functions of primary care. The purpose of this study was to explore the nature and strategic forms of integrated mental health care ...

Sept. 12, 2016 Europe

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

Interdisciplinary Medication Adherence Program: The Example of a University Community Pharmacy in Switzerland

The Community Pharmacy of the Department of Ambulatory Care and Community Medicine (Policlinique Médicale Universitaire, PMU), University of Lausanne, developed and implemented an interdisciplinary medication adherence program. The program aims to support and reinforce medication adherence through a multifactorial and interdisciplinary intervention. Motivational interviewing is combined with medication adherence electronic monitors (MEMS, Aardex MWV) and a report to patient, physician, nurse, and other pharmacists. This program has become a routine activity and was extended for use with all chronic diseases. From 2004 to 2014, there were 819 patient inclusions, and 268 patients were in follow-up in 2014. This paper ...

Sept. 12, 2016 Europe

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

Behavioural health consultants in integrated primary care teams: a model for future care

Significant challenges exist within primary care services in the United Kingdom (UK). These include meeting current demand, financial pressures, an aging population and an increase in multi-morbidity. Psychological services also struggle to meet waiting time targets and to ensure increased access to psychological therapies. Innovative ways of delivering effective primary care and psychological services are needed to improve health outcomes.

Aug. 24, 2016 Global

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

Association of Integrated Team-Based Care With Health Care Quality, Utilization, and Cost

The value of integrated team delivery models is not firmly established. So we evaluate the association of receiving primary care in integrated team-based care (TBC) practices vs traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs.

Conclusions: Among adults enrolled in an integrated health care system, receipt of primary care at TBC practices compared with TPM practices was associated with higher rates of some measures of quality of care, lower rates for some measures of acute care utilization, and lower actual payments received by the delivery system.

Aug. 11, 2016 Americas Global

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

The Value of Continuity between Primary Care and Surgical Care in Colon Cancer

Improving continuity between primary care and cancer care is critical for improving cancer outcomes and curbing cancer costs. A dimension of continuity, we investigated how regularly patients receive their primary care and surgical care for colon cancer from the same hospital and whether this affects mortality and costs.Receiving primary care and surgical care at the same hospital, compared to different hospitals, was associated with lower costs but still similar survival among stage I-III colon cancer patients. Nonetheless, health care policy which encourages further integration between primary care and cancer care in order to improve outcomes and decrease costs will ...