People-centred health care

In recent years, there has been increasing interest in the patient’s perspective of health care and how health systems can better respond to the needs of all health care stakeholders and constituencies in a holistic manner. Previous recommendations of Member States through the WHO Regional Committees for the Western Pacific and South-East Asia reflect the need to pursue work in the following: equity and fairness into policies; the development of programmes firmly grounded in ethical principles; the quality of health care and patient safety; human dignity, patients’ rights and needs, and the role of families, culture and society; the broader psychosocial and cultural determinants of health; and ethics related to medical practice, research and education. These issues have widespread relevance and significance. Improving health care quality and safety and enhancing the people’s experience of care require attention not only to health system design but also to the focus ...

IHF 40th World Hospital Congress

The IHF 40th World Hospital Congress will be held 31 October – 3 November 2016 in Durban, South Africa with the theme: Addressing the Challenge of Patient-centered Care and Safety.

The World Hospital Congress of the International Hospital Federation (IHF) is a unique global forum that brings together key drivers of national and international policy, management, financial trends and solutions in healthcare management and service delivery. Through this forum multidisciplinary exchange of knowledge, expertise and experiences are facilitated, together with dialogue on best practices in leadership in hospital and healthcare management and delivery of services.

For further information please click here: IHF 40th World Hospital Congress

Assessing health services delivery performance with hospitalizations for ambulatory care sensitive conditions

Health services delivery: a concept note

Presentation on the European Framework for Action on Integrated Health Services Delivery

17th International Conference in Integrated Care "Building a platform for integrated care: delivering change that matters to people"

The 16th International Conference in Integrated Care "Building a platform for integrated care: delivering change that matters to people" will incorporate the 5th World Congress on Integrated Care as it comes to Europe for the first time. It will take place in Dublin, Ireland, from the 8-10 May 2017. 

The conference themes include: Promoting the health and welfare of people, families and communities; Timely transitions: optimizing patient flow across care settings: Preventing and managing chronic disease: engaging and empowering people; Ageing health and well being; and Implementing integrated care.

For more information, please visit: http://www.integratedcarefoundation.org/icic17 

Healthy China : deepening health reform in China building high-quality and value-based service delivery

As many other countries, China faces big challenges to meet the health care needs of her citizens, associated with a rapidly aging society and increasing burden of non-communicable diseases (NCDs). Also, health costs have been growing at a rate higher than GDP growth since 2008.

Since the launch of health reform in 2009, China has invested significantly in health infrastructure at the grassroots level and made progress in building the primary care doctors system. Basic public health services capacity has been significantly enhanced. China is progressing quickly to achieving universal health coverage and some of the reform achievements have attracted worldwide attention.

The reform commanded many innovative pilots in health financing and service delivery at the local level and provided a strong foundation for the next stage of reform. This report aim to support China during this reform phase by recommending 8 sets of strategic reform directions, referred to as ...

Impact of Integrated Care Model (ICM) on Direct Medical Costs in Management of Advanced Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a commonly diagnosed condition in people older than 50 years of age. In advance stage of this disease, integrated care (IC) is recommended as an optimal approach. IC allows for holistic and patient-focused care carried out at the patient´s home. The aim of this study was to analyze the impact of IC on costs of care and on demand for medical services among patients included in IC. The high costs of care in advance COPD indicate the need for new forms of effective care. IC caussed a decrease in costs and in the number of hospitalization, with a simultaneous increase in the number of GP visits. 

Interventions and approaches to integrating HIV and mental health services: a systematic review

• Available literature on interventions integrating HIV and mental health services reveal that there is much diversity in the approaches adopted in combining treatment modalities; ranging from integration within a single facility, to multi-facility integration, and integrated care coordinated by non-physician case managers.

• Existing evidence, although limited, suggest that integrating HIV and mental health services may be linked to improved patient and service delivery outcomes in diverse settings.

• There is a need for higher quality and robustly designed studies to evaluate and compare integration models at different levels of service delivery in terms of long-term impact on patient outcomes and cost-effectiveness, particularly in low- and middle-income countries with high HIV and AIDS burden.

Better value primary care is needed now more than ever

Healthcare systems globally are fancing multiple challenges, with ageing populations, increasing chronic disease, rising multiborbidity, and innovative treatments and technologies all leading to rising costs. With finite resources, and an increasing recognition of the potential harms to patients of overdiagnosis and overtreatment, it is essential that resources are used optimally. This article explore how the value based healthcare framework can help decisions about how to allocate resources, and the importance of good evidence not only for patient treatment but the organisation of health services. 

Are low and high utilization related to the way GPs manage their practices? An observational study

General practice care plays a key role in keeping healthcare effective and cost-efficient. However, variation in the utilization rates of practices may reveal variation in practice performance. This research goal is to investigate whether the socio-demographic profile of the patient´s area of residence and practice organization characteristics influence the low or high utilization of general practice care. 

Developing and deploying a community healthcare worker-driven, digitally- enabled integrated care system for municipalities in rural Nepal

Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low- and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. This article describe the development of an integrated care system involving community healthcare worker networks that utilize a home-to-facility electronic health record platform for rural municipalities in Nepal.

Will Disruptive Innovation in Health Care Improve the Health of Populations?

Health care in the United States is long overdue for an upheaval. The mismatch between costs, by far the highest in the world, and health outcomes, among the worst in the high-income world, has long been glaring. Perhaps the good news is that the time for such an upheaval has come. At least 4 forces have been gathering steam, each promising to change the nature of health care and, in so doing, influence population health.

Project INTEGRATE: Developing a Framework to Guide Design, Implementation and Evaluation of People-centred Integrated Care Processes

People-centred integrated care is an acknowledged approach to improve the quality and effectiveness of health systems in delivering care around people’s needs and preferences. Nevertheless, more guidance on how to effectively design, implement and evaluate the care process of people-centred integrated care services is needed. Under Project INTEGRATE, a framework was developed to guide managers in the assessment, transformation and delivery of these health service innovations.

1st Transnational Conference on Integrated Community Care: "Making the case for Integrated Community Care"

This is a synthesis report of conference documents, discussions and learnings of the first conference in Hamburg, “Making the case for integrated community care”. This conferences aimed to develop a common understanding of the meaning of integrated community care and demonstrate through evidence the positive impact integrated community care can have on tackling inequalities, improving care experiences and care outcomes. This included the exploration of essential design elements in the provision of integrated community care that make the approach successful.

Thinking outside the system: the integrated care experience in Queensland, Australia

Health policy-makers are faced with a demand for health care that exceeds supply, driven in part by an ageing population and an increased prevalence of chronic disease. An integrated ‘people-centred’ model of care across primary, secondary and tertiary health care can strengthen the health system by streamlining services to improve the patient journey and outcomes.

Care coordination in the health-care service delivery: an elderly care perspective

The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic conditions. Care coordination is defined as a process where physicians, nurses and allied professionals work together to clarify responsibilities, care objectives, treatment plans and discharge plans for delivery of unified care. Patient-centricity is defined as an approach of delivering quality care to patients that focuses on creating a positive experience for them.

Comparative case studies in integrated care implementation from across the globe: a quest for action

Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. Furthermore, there is a complex interplay of factors at multiple levels of influence that are necessary for successful implementation of integrated care in health systems

Are patients ready for integrated person-centered care? A qualitative study of people with epilepsy in Ireland

The National Clinical Programme for Epilepsy (NCPE) in Ireland aims to deliver a holistic model of integrated person-centered care (PCC) that addresses the full spectrum of biomedical and psychosocial needs of people with epilepsy (PwE). However, like all strategic plans, the model encompasses an inherent set of assumptions about the readiness of the environment to implement and sustain the actions required to realize its goals. In this study, through the lens of PwE, the Irish epilepsy care setting was explored to understand its capacity to adopt a new paradigm of integrated PCC.  

SCIROCCO Exchange - Capacity-building support for integrated care

Integrated care is a recognised solution to address the challenge of ageing population. Hence, it is important to commit to opportunities that increase the readiness and capacity of regions to implement integrated care. Knowledge transfer has been greatly recognised as an effective enabler of capacity-building support. However, effective knowledge transfer and capacity-building support requires dedicated support and infrastructure to ensure that the flow of appropriate information and knowledge between adopting and transferring entities is tailored to the local context and maturity of the particular healthcare system seeking the support. This is a precondition to help health and care authorities to build their capacity for the successful transition towards integrated care.

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 wide range of interventions aiming to address issues of integration across healthcare and between health and social care. Improved discharge planning and flow of care, and improved sharing of knowledge between practitioners, are essential components of new models of integrated care. Discharge of the patient from the hospital to the ...

Policy framework for building integrated care for TB patients in Romania: setting up the scene

ARIA 2019: An Integrated Care Pathway for Allergic Rhinitis in Portugal

The Allergic Rhinitis and Its Impact on Asthma (ARIA) initiative started more than 20 years ago and has developed and disseminated evidence-based guidelines and projects in the field of allergic rhinitis. This initiative is currently focused on providing patient-centred guidelines that contribute to an integrated care pathway between the various levels of care and take advantage of digital solutions, and the introduction of integrated care pathways in clinical practice has been recommended. In this article we describe the adaptation for Portugal of the ARIA Integrated Care Pathways document. After a brief review of the epidemiology and impact of allergic rhinitis in Portugal and the activities carried out in Portugal within the ARIA initiative, we describe the broad knowledge base used for the development of recommendations for the pharmacological treatment of allergic rhinitis, and these recommendations are based on the GRADE methodology, real world evidence acquired by mobile technology (mHealth) and ...

Addressing Common Challenges in the Implementation of Collaborative Care for Mental Health: The Penn Integrated Care Program

The purpose of this article was to develop and implement a new model of collaborative care that includes a triage and referral management system. The authors present initial implementation metrics using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.  

Implementing Mobile Health?Enabled Integrated Care for Complex Chronic Patients: Intervention Effectiveness and Cost-Effectiveness Study

Integrated care can generate health and social care efficiencies through the defragmentation of care and adoption of patient-centered preventive models. eHealth can be a key enabling technology for integrated care.

Games of uncertainty: the participation of older patients with multimorbidity in care planning meetings – a qualitative study

Active patients lie at the heart of integrated care. Although interventions to increase the participation of older patients in care planning are being implemented in several countries, there is a lack of knowledge about the interactions involved and how they are experienced by older patients with multimorbidity. We explore this issue in the context of care-planning meetings within Norwegian municipal health services.

Implementation of Integrated Primary Care for Patients with Diabetes and Hypertension: A Case from Slovenia

Research on models of integrated health care for hypertension and diabetes is one of the priority issues in the world. There is a lack of knowledge about how integrated care is implemented in practice. Our study assessed its implementation in six areas: identification of patients, treatment, health education, self-management support, structured collaboration and organisation of care.

Proposals for person-centred care in the COVID-19 era. Delphi study

In this COVID-19 era, we need to rethink the criteria used to measure the results of person-centred care strategies. The objective of this study is to identify priorities, and criteria that health services can use to pursue actually the goal of achieving person-centred care.

The Evolving Roles of Nurses Providing Care at Home: A Qualitative Case Study Research of a Transitional Care Team

Transitional care teams have been introduced to enable the seamless transfer of patients from acute-care to the home settings. A qualitative case study of the transitional care team was conducted to examine the roles of transitional care nurses in an integrated healthcare system and how the integrated healthcare system influences their evolving roles.  

Rethinking Primary Care Delivery Models: Can Integrated Primary Care Teams Improve Care Experience?

Integrated Primary Care Teams (IPCTs) have four key characteristics (intensive interdisciplinary practice; advanced nursing practice with an expanded role; group practice; increased proximity and availability) aimed at strengthening primary care in Quebec, Canada. The purpose of this paper is to examine the care experience over time of patients who have an IPCT as their primary source of care.

Social workers coordination in primary healthcare for patients with complex needs: A scoping review

Care coordination has been part of social work for some time. It has been recognized as contributing to care coordination for long-term care for the elderly and mental health but less is known about their contribution in primary care with patients with complex health and social needs. As social workers are increasingly present in primary healthcare, this scoping review aims to provide a synthesis of social workers’ coordination activities for patients with complex needs in primary healthcare.

Priorities in integrating primary and secondary care: a multimethod study of GPs

Throughout the world, healthcare policy has committed to delivering integrated models of care. The interface between primary–secondary care has been identified as a particularly challenging area in this regard. To that end, this study aimed to examine the issue of integrated care from general practitioners’ (GPs) perspectives in Ireland.