Barriers and facilitators to the implementation of person-centred care in different healthcare contexts

Background

Health and social care in aging population: an integrated care institution for the elderly in Greece

The purpose of this article was to describe the nature of the services actually offered to the elderly in Greece by an institution of integrated care, as opposed to those that should be offered according to the relevant law, and to investigate the factors influencian the supply of those services. 

Changes in Hospital–Physician Affiliations in U.S. Hospitals and Their Effect on Quality of Care

Many U.S. policymakers believe that increased integration between hospitals and physicians may foster better care and potentially decrease health care spendind. The logic behind this notion is straightforward: When physicians are employed or otherwise more substantially influenced by the hospitals in which the work, they are less likely to focus on generating revenue to maintain an independent practice and more likely to focus on patient care. The objetive of this article was to examine changes in United States acute care hospitals that reported employment relationships with their physicians and to determine whether quality of care improved after the hospitals switched to this integration model. 

Case management for integrated care of frail older people in community settings

Demographic changes and advances in medical care and technology have led to an ageing population. Despite gains in life expectancy, compression of morbidity in later life has not been achieved, meaning that although growing numbers of older people are living longer, they are doing so with one or more long?term conditions. A key driving force for international policy agendas worldwide is to improve the quality, efficiency and safety of health and care services through the delivery of effective integrated care systems. Integrated care can be broadly defined as "an organising principle for care delivery that aims to improve patient care and experience through improved coordination", and such approaches are being increasingly implemented as a key policy in many countries. This review will focus on case management as one service model for delivering integrated care, among others. 

Strengthening performance-based financing as a health system approach for quality improvement

Over the last decade, a significant reduction of maternal and child mortality has been achieved in low- and middle-income countries (LMICs). This is largely attributable to the substantial improvement in access to essential reproductive, maternal and child health services. However, in some countries, expansion of health services has not resulted in the expected mortality reduction. Low quality of care (QoC) is an important cause of this discrepancy, and it calls for putting quality improvement on the global health agenda. As an approach to enhance QoC in LMICs, performance-based financing (PBF), which incentivizes health providers based on predetermined indicators, has been piloted or implemented in more than 30 countries. More importantly, PBF has been used as an important vehicle to catalyze health system reforms to enhance service delivery, including quality improvement (QI), in many countries.

This paper takes a system perspective to examine the current practice of PBF in strengthening health ...

A compendium of tools and resources for improving the quality of health services

In an attempt to consolidate the work of the WHO Department of Service Delivery and Safety (SDS) on quality improvement, a SDS cross-cut team has produced a compendium of tools and resources on quality improvement, developed within the SDS, that are applicable for country support. It includes resources on IPCHS and community engagement among others. It also includes practical examples of how the tools and resources have been applied in-country, including relevant links with other areas, such as measurement.  Ministries of health, facility quality improvement teams, researchers, development agencies and any organization or individual working to improve the quality of health service delivery can benefit from this compendium.

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.

Closing the gap: Key areas for action on the health and care workforce

Staffing is the make-or-break issue for the NHS in England. Workforce shortages are already having a direct impact on patient care and staff experience. Urgent action is now required to avoid a vicious cycle of growing shortages and declining quality. The workforce implementation plan to be published later this year presents a pivotal opportunity to do this. In this joint report with the Nuffield Trust and the Health Foundation, they set out a series of policy actions that, evidence suggests, should be at the heart of the workforce implementation plan. They focus on nursing and general practice, where the workforce problems are particularly severe.

Care Redesign Survey: To Improve Chronic Disease Care, Change the Payment Model

Many health care organizations are reasonably effective in treating chronic diseases, but they are limited from doing better by fee-for-service payment, which remains the predominant payment model in the United States. The latest NEJM Catalyst Insights Council report serves as a snapshot in time, showing the intent of health care providers to be proactive in treating chronic disease, but limitations in their ability to address population health

Stakeholder Perceptions and Context of the Implementation of Performance-Based Financing in District Hospitals in Mali

To improve the performance of the healthcare system, Mali’s government implemented a pilot project of performance-based financing (PBF) in the field of reproductive health. It was established in the Koulikoro region. This research analyses the process of implementing PBF at district hospital (DH) level, something which has rarely been done in Africa.

Giving patients a voice: implementing patient and public involvement to strengthen research in sub-Saharan Africa

Patient and public involvement (PPI) is recognised as a valuable tool in improving the quality and relevance of research. Defined as "research being carried out "with" or "by" members of the public rather than "to", "about" or "for" them", PPI is a method of involving patients and the public in the design, conduct and dissemination of research and services that affect them, providing for a more democratic approach and patient empowerment.

Person-centred care 4 sustainable health systems - How to transform health care in the post-pandemic era

This virtual conference, organised by the European Project COSTCARES (www.costcares.eu), a European network for improved quality of care and cost containment, will focus on the implementation of person-centred care from different European perspectives.

Your are welcome to participate in this free event. Registration deadline:10 March 2021

Further information, panelists and programme

Registration

Implementing High-Quality Primary Care Through a Health Equity Lens

The COVID-19 pandemic highlighted the importance of centering health equity in future health system and primary care reforms. Strengthening primary care will be needed to correct the longstanding history of mistreatment of First Nations/Indigenous and racialized people, exclusion of health care workers of color, and health care access and outcome inequities further magnified by the COVID-19 pandemic.

The National Academies of Sciences, Engineering, and Medicine (NASEM) released a report on Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, that provided a framework for defining high-quality primary care and proposed 5 recommendations for implementing that definition. Using the report’s framework, we identified health equity challenges and opportunities with examples from primary care systems in the United States and Canada. We are poised to reinvigorate primary care because the recent pandemic and the attention to continued racialized police violence sparked renewed conversations and collaborations around equity, diversity, inclusion ...

Primary Health Care the heart of every health system. How do we get there?

A ten-part seminar series, run by the London School of Hygiene & Tropical Medicine, providing an overview of the key features and functions of Primary Health Care (PHC), the potential of PHC in all health systems and its role in achieving universal health coverage. The sessions draw on examples across different settings.

In this final session in the series on “Primary Health Care: The heart of every health system” a panel of cross-country experts will reflect on their key takeaways from the series and consider what more needs to happen to support countries to place PHC at the heart of their health system.

If you would like to submit a question to our panel please submit these here. 

Speakers

• Lakshmi Balaji is a Global Health and International Development leader, and until recently was Chief of PHC and Health Systems Strengthening at UNICEF Headquarters.  
• Dina Balabanova is a Professor of Health Systems ...