The rising burden of diabetes and hypertension in southeast asian and african regions: need for effective strategies for prevention and control in primary health care settings.

Aim. To review the available literature on burden of diabetes mellitus (DM) and hypertension (HTN) and its coexistence in Southeast Asian (SEA) and the African (AFR) regions and to suggest strategies to improve DM and HTN prevention and control in primary health care (PHC) in the two regions. Methods. A systematic review of the papers published on DM, HTN, and prevention/control of chronic diseases in SEA and AFR regions between 1980 and December 2012 was included. Results. In the year 2011, SEA region had the second largest number of people with DM (71.4 million), while the AFR region had the smallest number (14.7 million). Screening studies identified high proportions (>50%) of individuals with previously undiagnosed HTN and DM in both of the SEA and AFR regions. Studies from both regions have shown that DM and HTN coexist in type 2 DM ranging from 20.6% in India ...

Unintended costs of health care integration.

Decreasing -or, at least, containing- costs is one of the most important values usually attributed to health services integration. In this post published in the Harvard Medical School website, cost containing is questioned according to a paper published in JAMA Internal Medicine, where researchers describe how anual outpatient spending has grown in some integrated areas by 3.1 percentage point even when changes in use of outpatient care were minimal.

In this text, the author hypothesizes that integration between physicians and hospitals turn their position with insurers stronger, specially for prices of outpatient care. Health care integration may, in some situations, promote positions of power in the market, so that could have an influence in price negotiation and healthcare spending.

This unexpected cost increasing should be considered when designing integrated care policies and incentives, in order to avoid unintended spending cost that could threaten the sustainability of integrated health services.

Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses

Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a “diagonal approach.” We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health ...

Health services delivery: a concept note

Step-by-step guide for developing integrated health services delivery profiles

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

The creative potential of health work to develop an integrated care model in Brazilian primary health care  

In November 2015, at the 3rd World Congress on Integrated Care and 8th National Congress of Integrated Medicine, “Co-producing High Quality People-Centered Integrated Care for ALL”, Debora Santos presented her PhD research on primary health care teams in Alagoas, the most unequal state in Brazil. According to Debora Santos, while Brazil's Unified Health System (SUS) is headed by principles of integrated care, in practice a biomedical conception of health typically prevails instead of one focused on integrated care. Therefore, the objective of her research was to identify potential ways to develop an integrated care model of primary health care focused on the principles of social health rights, integrated access, equity, team work and health promotion. Through focus groups and interviews with primary health care teams she identified several challenges and potentialities for integrated care. For example,  the teams faced both objective (clinical) and subjective (emotional) needs but had limited ...

Strengthening the model of primary health care in Estonia (2016)

Progress on integrated care

This year´s conference of the International Foundation for Integrated Care (IFIC16) in Barcelona attracted over 1000 delegates and participants. Shortly afterwards, the World Health assembly adopted a global framework on integrated people-centred health services develope by the WHO, and an alliance of organisations created a European call for action to implement the framework at EU level. 

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Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic  diseases. International evidence suggest that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA. 

WHO: What is people-centred care?

Globally, 1 in 20 people still lacks access to essential health services that could be delivered at a local clinic instead of a hospital. And where services are accessible, they are often fragmented and of poor quality. WHO is supporting countries to progress towards universal health coverage by designing health systems around the needs of people instead of diseases and health institutions, so that everyone gets the right care, at the right time, in the right place.

WHO: What is people-centred care?

Globally, 1 in 20 people still lacks access to essential health services that could be delivered at a local clinic instead of a hospital. And where services are accessible, they are often fragmented and of poor quality. WHO is supporting countries to progress towards universal health coverage by designing health systems around the needs of people instead of diseases and health institutions, so that everyone gets the right care, at the right time, in the right place.

What’s integration got to do with it?

Observations and Lessons from the Franciscus Gasthuis & Vlietland Study Trip to North-West London.

Challenges and achievements in integrated care: different health and social care providers working together. Successful projects that show that this is the way

The Catalan health system is a public healthcare system, funded by taxes, with universal coverage and public healthcare services portfolio. There´s a mixed healthcare providers network. Delivery of integrated health and social care witha a shift to a patient-centered model is one of the main challenges of our public system. this artcile share three experiences of different models developed to improve integration of social and healthcare services, to guarantee the continuum of care and to achieve quality health and social care outcomes. 

Utilization of community-based health planning and services compounds in the Kintampo North Municipality: a cross-sectional descriptive correlational study

The Community-based Health Planning and Services (CHPS) initiative was introduced to improve coverage and utilization of basic health services for people in remote rural communities whose use of orthodox health services was hitherto limited by distance. So the objectives of this study were to examine the extent of patronage of CHPS compounds in the Kintampo North Municipality , factors associated with their use and challenges faced by community members regarding the use of these facilities. 

Approaches towards improving the quality of maternal and newborn health services in South Asia: challenges and opportunities for healthcare systems

South Asia is experiencing a dismal state of maternal and newborn health (MNH) as the region has been falling behind in reducing the levels of maternal and neonatal mortality. Most of the efforts are focused on enhancing coverage of MNH services; however, quality remains a serious concern if the region is to achieve expected outcomes in terms of standardised MNH services within healthcare delivery systems. This research consists of a review of south Asian quality improvement approaches/interventions, specifically implemented for MNH improvement. 

Translating the Elements of Health Governance for Integrated Care from Theory to Practice: A Case Study Approach

Against a paucity of evidence, a model describing elements of health governance best suited to achieving integrated care internationally was developed. The aim of this study was to explore how health meso-level organizations used, or planned to use, the governance elements. 

Service Delivery Models to Maximize Quality of Life for Older People at the End of Life: A Rapid Review

In an era of unprecedented global aging, a key priority is to align health and social services for older populations in order to support the dual priorities of living well while adapting to a gradual decline in function. The aimed of this review was to provide a comprehensive synthesis of evidence regarding service delivery models that optimize the quality of life (QoL) for older people at the end of life across health, social, and welfare services worldwide.

A Realist Evaluation of Local Networks Designed to Achieve More Integrated Care

Not surprisingly given their multi-component nature, initiatives to improve integrated care often evolve to find the best way to bring about change. This paper provides an example of how an evaluation evolved alongside such an initiative designed to better integrate care across primary, community and hospital services in South Auckland, New Zealand.

The impact of a comprehensive electronic patient portal on the health service use: an interrupted time-series analysis

EPPs hold promise for reducing hospital readmissions. Certain patient populations with chronic conditions may differentially benefit from portal use depending on their needs for communication with their providers.
However, there is little empirical research on the potential benefit that electronic patient portals (EPP) can have on the care quality and health outcomes of diverse multi-ethnic international populations. The purpose of this study is to determine the extent to which an EPP was associated with improvements in health service use.

National Forum on Integrated Care in Ireland (NFICI) 2020

In light of the current COVID-19 pandemic and the travel restrictions in place, we regretfully inform you that the National Forum on Integrated Care in Ireland has been cancelled.

IFIC Ireland in association with the International Foundation for Integrated Care (IFIC), the UCD Centre for Integrated Care and Improvement Studies (UCD CICIS) and the Health Service Executive (HSE) Ireland presents “Transforming Health and Social Care in Ireland: Delivering Lifelong People-centred Care” on Wednesday, 6 May 2020 in O’Reilly Hall University College Dublin. The forum is attended by up to 300 delegates from across Ireland and Northern Ireland and includes Health and Social Care Services Mangers, Clinicians and System leads, Academics leading in the field of integrated care, and a wide range of not for profit patient representative organisations and private sector providers of care services.

NACIC2021 – 1st North American Conference on Integrated Care, Toronto, Canada

Evaluating Integrated Care for Children: A Clarion Call or a Call for Clarity?

“Integrated care” is often used to describe concepts such as coordinated and seamless care instead of the often fragmented and episode care that patients receive. Integrated care reflects the aspirations of modern health care systems and receives significant academic attention. 

This review is about what extent integration is an intervention in need of evaluation or simply a key health system outcome, as has been proposed for the medical home.

Leadership for integrated care: a case study

Integration of health services involves multiple interdependent leaders acting at several levels of their organisation and across organisations. This paper aims to explore the complexities of leadership in an integrated care project and aims to understand what leadership arrangements are needed to enable service transformation.

This study provides insights into the interdependencies of leadership across multiple levels and proposes steps to maximise the success of complex transformational projects.

Primary care networks explained

The National Health Service (NHS) is the umbrella term for the publicly-funded healthcare systems of the United Kingdom (UK). Since 1948 they have been funded out of general taxation. There are four systems, one for each of the four countries of the UK: The NHS in England, NHS Scotland, NHS Wales and Health and Social Care in Northern Ireland. They were established together in 1948 as one of the major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery a health service based on clinical need, not ability to pay. Each service provides a comprehensive range of health services, free at the point of use for people ordinarily resident in the UK, apart from dental treatment and optical care. In England, NHS patients have to pay prescription charges; some, particularly those receiving state benefits, are ...

Webinar: A European standard for patient participation in person-centred care

Welcome to our free webinar:

Webinar: A European standard for patient participation in person-centred care

Date: Thursday 25 February 2021

Time: 14.00-15.30 CET (GMT+1)

Registration required. Click here to register.

The webinar link will be sent to you when you have registered.

Event details: The European standard Patient involvement in healthcare - Minimum requirements for person-centred care (CEN/TC 450) was adopted in 2020. It can be used to facilitate the introduction of, work with and research on person-centred care in a number of different ways by health and care actors, patient organisations, researchers, businesses and others. It is the first in its field in Europe.

Join our webinar to hear three members of the standardisation committee present the standard, along with potential areas of use.

The webinar will be held in English, and it will be recorded.

Interaction: We welcome your questions, either during the webinar or ...

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.  

Development of a model to deliver primary health care in Qatar

Healthcare providers around the world are seeking to manage the rising burden of chronic conditions against a backdrop of both growing and ageing populations as well as greater expectations of health services. This paper describes the development of an integrated primary care model ‘the family medicine model (FMM)’ to deliver primary healthcare in Qatar to better address some of the healthcare challenges faced. The proposed model is an innovative approach which utilises and integrates these components to deliver holistic primary care. It is anticipated that its introduction will help redesign and integrate the way primary healthcare is delivered to the population of Qatar in helping patients manage their own health and reduce the numbers that need to be admitted to secondary care, improving patients’ independence and well-being as well as dramatically reducing the cost to the overall health system.

Values Underpinning Integrated, People-Centred Health Services: Similarities and Differences among Actor Groups Across Europe

In addition to the functional aspects of healthcare integration, an understanding of its normative aspects is needed. This study explores the importance of values underpinning integrated, people-centred health services, and examines similarities and differences among the values prioritised by actors across Europe.