Developing family medicine and primary care worldwide through global collaboration and co-learning

The COVID-19 pandemic represents one of the rare health emergencies that all humans on our planet have experienced simultaneously.   Global news feeds provide us with near instantaneous updates regarding case numbers and disease impacts that not only affect our immediate community, but also other communities and contexts worldwide.  In this sense, COVID-19 has truly highlighted our experience as global citizens.

Primary care (in its various global iterations, such as family medicine and general practice) is increasingly recognized as a keystone for improving health outcomes worldwide.  Most certainly, we are beginning to see the converse impact that the pandemic has had on the practice of primary care.  Earlier this year the Canadian Family Physician blog highlighted this experience through a podcast series developed by Dr. Christine Gibson with the support of the Besrour Centre for Global Family Medicine.  Representing family physicians and primary care educators from 11 countries, these podcast narratives ...

Successful implementation of integrated care in Slovenian primary care

For the purpose of celebrating the 40th anniversary of Alma Ata declaration, the WHO published a successful model of integrated patient care being performed in Slovenia. After two years, the WHO experts evaluated the success in practise during a visit to the Slovenian primary care environment. This report showed that Slovenia was a notable exception regarding developing effective primary care systems. The country has an impressive primary care which performs very well.

Capacity building of health care professionals to perform interprofessional management of non-communicable diseases in primary care – experiences from Ukraine

Non-communicable diseases are leading causes of death and disability across the world. Countries with the highest non-communicable disease (NCD) burden in the WHO European Region are often those that have some of the greatest health system challenges for achieving good outcomes in prevention and care. The aim of this study was to evaluate the effect of an interprofessional capacity building intervention carried out in Ukraine to improve the management non-communicable diseases in primary health care.

EFPC 2021 BERGEN CONFERENCE. Primary and long-term care in the age of changing boundaries: Policy, practice and imagination

A Community Resource Navigator Model: Utilizing Student Volunteers to Integrate Health and Social Care in a Community Health Center Setting

While unmet social needs are major drivers of health outcomes, most health systems are not fully integrated with the social care sector to address them. 

This case study describes the development and implementation of a model utilizing student volunteer community resource navigators to help patients connect with community-based organizations. The authors then detail initial implementation outcomes and practical considerations for future work.

Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review

In Ireland, as in many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of chronic disease.

Integrated care is an approach to healthcare systems delivery that aims to minimise fragmentation of patient services and improve care continuity. To this end, how best to integrate primary and secondary care is a challenge.

This paper aims to undertake a scoping review of empirical work on the integration of primary and secondary care in relation to chronic disease management.

Tackling COPD misdiagnosis in primary care through integrated care

COPD specific integrated care services have in the past been shown to improve patients’ outcomes and reduce costs. However, tackling the issue of COPD misdiagnosis within primary care is potentially an additional purpose integrated care can serve.

IFIC Ireland Patient Empowerment Mini-Series with CEmPaC

The World Health Organization (WHO) defines Empowerment for Health as ‘a process through which people gain greater control over decisions and actions affecting their health. Empowerment may be a social, cultural, psychological or political process through which individuals and social groups are able to express their needs, present their concerns, devise strategies for involvement in decision-making, and achieve political, social and cultural action to meet those needs.’

Impact of Proactive Integrated Care on Chronic Obstructive Pulmonary Disease

In the United States, chronic obstructive pulmonary disease (COPD) affects over 16 million people, costs $32 billion per year, and is the fourth leading cause of death.Exacerbations of COPD are among the most devastating complications of COPD, because they greatly increase the risk of death and account for 60% of COPD costs.Efforts have focused on standardizing recommendations for therapies that improve symptoms and limit exacerbations, identifying patients who might benefit from these treatments, and increasing compliance with recommended therapies.Surprisingly, only about 50% of COPD patients receive recommended therapies for COPD and COPD exacerbations, up to two-thirds of COPD exacerbations are not reported to health care providers,and only half of primary care physicians use COPD guidelines. Therefore, novel methods to improve health care delivery could bring substantial benefits, and may be particularly important given the disruption in health care due to the recent coronavirus 2019 (COVID-19) pandemic.

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.  

The Seniors' Community Hub: An Integrated Model of Care for the Identification and Management of Frailty in Primary Care

Integrated models of primary care deliver the comprehensive and preventative approach needed to identify and manage frailty in older people. Seniors' Community Hub (SCH) was developed to deliver person-centered, evidence-informed, coordinated, and integrated care services to older community dwelling adults living with frailty. This paper aims to describe the SCH model, and to present patient-oriented results of the pilot.

Clustering Complex Chronic Patients: A Cross-Sectional Community Study From the General Practitioner’s Perspective

A Validation Study of the Rainbow Model of Integrated Care- Measurement Tool for Patients in China

The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. The aim of this paper is to modify the original patient version of the RMIC-MT for the Chinese primary care context and validate its psychometric properties.

General Practitioners and Community Pharmacists’ Collaboration in Primary Care: Small Steps for a Major Change

Healthcare authorities worldwide search for ways to develop integrated care and interprofessional collaboration. In Belgium, Medical-Pharmaceutical Concertation (MPC) was introduced as a format to promote constructive dialogues between GPs and community pharmacists (CPs) with a focus on pharmacotherapy.

This study aimed to evaluate the implementation of MPC from the perspective of healthcare authorities and GPs/CPs.

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.

Readiness to deliver person-focused care in a fragile situation: the case of Mental Health Services in Lebanon

Evidence suggests wide variability in the provision of mental healthcare across countries. Countries experiencing fragility related risks suffer from a high burden of mental-ill health and additionally have limited capacity to scale up mental health services given financial and human resource shortages. Integration of mental health services into routine primary care is one potential strategy for enhancing service availability, however little is known about the experiences of currently active health care providers involved in mental health and psychosocial support service (MHPSS) provision at primary care level. This study aims to determine how healthcare providers offering MHPSS services at primary care levels in Lebanon perceive mental health and the health system’s ability to address the rising mental ill-health burden with a view to identify opportunities for strengthening MHPSS service implementation geared towards integrated person focused care model.

Care Integration in Primary Dementia Care Networks: A Longitudinal Mixed-Methods Study

Currently, care integration for community-dwelling persons with dementia is poor and knowledge on how to effectively facilitate development of integrated dementia care is lacking. The DementiaNet program aims to overcome this with a focus on interprofessional collaboration. The DementiaNet approach enables a transition towards more mature networks. Identified success factors provide better understanding of how network maturity can be achieved and gives guidance to future care integration strategies.

Association between doctor-patient familiarity and patient-centred care during general practitioner's consultations: a direct observational study in Chinese primary care practice

Patient-centred care is a core attribute of primary care. Not much is known about the relationship between patient-centred care and doctor-patient familiarity. This study aimed to explore the association between general practitioner (GP) perceived doctor-patient familiarity and the provision of patient-centred care during GP consultations.

1st All-Ireland Conference on Integrated Care “Transforming Health and Social Care across Ireland: Delivering Lifelong People-centred Care”

IFIC Ireland in association with the International Foundation for Integrated Care (IFIC) presents “Transforming Health and Social Care across Ireland: Delivering Lifelong People-centred Care” on Thursday, 10 March 2022 in O’Reilly Hall University College Dublin. 

The forum is attended by up to 300 delegates from across the island of 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. 

A number of policy frameworks have recently been developed to support the movement towards a more coordinated and holistic approach to improving population across the island of Ireland. The?Sla?intecare?report, a ten-year strategy for health care and health policy in Ireland, emphasises the importance of integrated care and shifting care out of hospitals and into the primary and community ...

Patient-centered care in musculoskeletal practice: Key elements to support clinicians to focus on the person

Musculoskeletal rehabilitation, including physiotherapy, needs to move towards a broader biopsychosocial understanding of musculoskeletal conditions and the delivery of high-value care for people with persistent pain conditions, in which a patient-centered approach is a key feature. However, it has been reported that clinicians experience difficulties with integrating patient-centered care principles into their clinical practice. Based on a focused symposium about patient-centered care for patients with musculoskeletal conditions, held during the online 2021 World Physiotherapy Congress, the purpose of this article is to share key elements of the content of this symposium with a wider audience, aimed at enabling clinicians to enhance patient-centeredness in their current practice. These key elements include establishing meaningful connections, deciding together and self-management support. Moreover, challenges on patient-centered care in low/middle income countries will be discussed and recommendations to implement patient-centered care in clinical practice will be provided.

Highlights

• Patient-centered care is important in people ...

Community Volunteers and Primary Care Providers Supporting Older Adults in System Navigation: A Mixed Methods Study

Primary care providers and community volunteers have important roles in supporting patient system navigation and utilization of community-based health and social services (CBHSS). This study aimed to explore the experiences and impacts of system navigation in a complex intervention supporting older adults. Primary care teams’ practice of system navigation was impacted by programme participation, including through learning about local CBHSS.

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria. This project adapted the World Health Organization’s Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG), emphasizing stigma reduction among trainees. This convergent mixed-methods proof-of-concept study evaluates the HAPPINESS pilot project mhGAP-IG training’s impact on mental illness stigma among trainees and barriers, facilitators, and opportunities to consider for project improvement.

Facilitating integration through team-based primary healthcare: A cross-case policy analysis of four Canadian provinces

Team-based care can improve integrated health services by increasing comprehensiveness and continuity of care in primary healthcare (PHC) settings. Collaborative models involving providers from different professions can help to achieve coordinated, high-quality person-centred care.

In Canada, five key components were found that influenced IPHC and integrated health services: patient-centred care; team structures; information systems; financial management; and performance measurement. 

Integrated care systems need to be different - but how exactly?

ICSs are intended to be a fundamental departure from previous NHS structures with a different type of leadership based on partnership, in which local partner organisations hold collective responsibility for resource use and outcomes. However, as ICSs take on statutory responsibilities for the first time later this year (assuming the Heath and Care Bill gains parliamentary approval) there is a risk of recreating established ways of working within the new structures. To live up to their promise, what are the things that should be ‘different’ about ICSs?

First, the concept of equal partnership between the NHS, local government, voluntary sector and others needs to be at the core of how these reforms are implemented. ICSs started their lives as informal partnerships operating through soft power and influence. The Health and Care Bill changes this by putting ICSs on a statutory footing, but partnership-working and collective responsibility need to remain at ...

Paediatric integrated care in the primary care setting: A scoping review of populations served, models used and outcomes measured

Paediatric integrated care (PIC), which involves primary care and behavioural health clinicians working together with patients and families, has been promoted as a best practice in the provision of care. In this context, behavioural health includes behavioural elements in the care of mental health and substance abuse conditions, chronic illness and physical symptoms associated with stress, and addressing health behaviours. Models of and contexts in which PIC has been applied vary, as do the outcomes and measures used to determine its value. Thus, this study seeks to better understand (1) what paediatric subpopulations are receiving integrated care, (2) which models of PIC are being studied, (3) what PIC outcomes are being explored and what measures and strategies are being used to assess those outcomes, and (4) whether the various models are resulting in positive outcomes. These questions have significant policy and clinical implications, given current national- and state-level efforts aimed ...

Healthcare provider person-centred practice: relationships between prerequisites, care environment and care processes using structural equation modelling

The translation of person-centred care concepts into practice requires fulfilment of necessary components, including person-centred values and practice held by the employees and having a supportive system. The objectives of this study were multifold: firstly, to evaluate the measurement model, secondly, to examine the roles of prerequisite or attributes of healthcare providers and care environment and how they affect delivery of person-centred processes; and finally, to examine the mediating effect of care environment towards the relationship between prerequisite and care processes.

Examining telehealth use among primary care patients, providers, and clinics during the COVID-19 pandemic

At the onset of COVID-19, there was a rapid expansion of telehealth (video/telephone) visits to maintain delivery of primary care (PC) services at the Veterans Health Administration (VA). This study examines patient, provider, and site-level characteristics of any virtual and video-based care in PC.

Transforming Primary Care in New York Through Patient-Centered Medical Homes: Findings From Qualitative Research

he patient-centered medical home (PCMH) model, an important component of healthcare transformation in the United States, is an approach to primary care delivery with the goal of improving population health and the patient care experience while reducing costs. PCMH research most often focuses on system level indicators including healthcare use and cost; descriptions of patient and provider experience with PCMH are relatively sparse and commonly limited in scope. This study, part of a mixed-methods evaluation of a multi-year New York State initiative to refine and expand the PCMH model, describes patient and provider experience with New York State PCMH and its key components.

Person-centred care in primary care: What works for whom, how and in what circumstances?

This rapid realist review aims to explain how and why person-centred care (PCC) in primary care works (or not) among others for people with low health literacy skills and for people with a diverse ethnic and socioeconomic background, and to construct a middle-range programme theory (PT). The middle-range PT demonstrates that healthcare professionals (HCPs) should be trained and equipped with the knowledge and skills to communicate effectively (i.e. in easy-to-understand words, emphatically, checking whether the patient understands everything, listening attentively) tailored to the wishes, needs and possibilities of the patient, which may lead to higher satisfaction.

Priority setting and cross-country learning: the relevance of TO-REACH for primary care

To inform the primary care community about priorities for research in primary care as came up from the European project TO-REACH and to discuss transferability of service and policy innovations between countries. The large variation in service organisation and policy around primary care in Europe is a huge potential for cross-country learning. 

TO-REACH stands for Transfer of Organizational innovations for Resilient, Effective, equitable, Accessible, sustainable and Comprehensive Health services and systems.

Resilience of the primary health care system – German primary care practitioners’ perspectives during the early COVID-19 pandemic

Primary care is a relevant pillar in managing not only individual, but also societal medical crises. The COVID-19 pandemic has demanded a rapid response from primary care with interventions in the health care system. The aim of this paper was to explore the responses of primary care practitioners (PCP) during the early COVID-19 pandemic and to analyze these with a view on the resilience of the primary health care system from the PCPs perspective.

Informing the implementation and use of person-centred quality indicators: a mixed methods study on the readiness, barriers and facilitators to implementation in Canada

Person-centred care (PCC) is a key component of high-quality healthcare, which actively engages patients and their caregivers in care decisions and considers patient needs, preferences and values. A focus on ‘person-centredness’ as opposed to ‘patient-centredness’ promotes a more holistic perspective on care, which is not limited to a person’s disease or illness, but also acknowledges the factors that influence a person’s well-being.PCC is a model of care that remains aspirational for many healthcare jurisdictions and sectors of care. However, in practice it has been challenging to implement as it requires changes in healthcare structures and processes.

Exploring Intra and Interorganizational Integration Efforts Involving the Primary Care Sector – A Case Study from Ontario

he primary care sector is uniquely positioned to lead the coordination of providers and organizations across health and social care sectors. This study explores whether intraorganizational (professional) integration within a primary care team might be related to interorganizational integration between primary care and other community partners involved in caring for complex patients.

Continuity of Care and Healthcare Costs among Patients with Chronic Disease: Evidence from Primary Care Settings in China

Though critical to primary care, continuity of care has rarely been examined in China. This study aims to assess the relationship between continuity of care and healthcare costs among patients with chronic diseases within primary care settings in China.

A Systematic Review of Interventions that Use Multidisciplinary Team Meetings to Manage Multimorbidity in Primary Care

Multidisciplinary team (MDT) meetings could facilitate coordination of care for individuals living with multimorbidity, yet there is limited evidence on their effectiveness. We hence explored the common characteristics of MDT meetings in primary care and assessed the effectiveness of interventions that include such meetings, designed to improve outcomes for adults living with multimorbidity.

Common procedures of remote measurement-based care in an integrated behavioural health context: protocol for a scoping review

Integrated behavioural health, a model of care that embeds mental health services in primary care, can potentially increase access to mental healthcare. With the increase in health information technologies, remote measurement-based care (RMBC) presents an opportunity to improve support of integrated care. This scoping review will comprehensively examine what common procedures are followed when RMBC for mental health is tested in integrated care settings.

A proposal to reform general practice and enable digital healthcare at scale

General practice has always been the foundation and gateway to the NHS. However the problems are mounting up: a stretched and increasingly burnt-out workforce, no systematic reporting or analysis of activity and demand, fragmentation with secondary care, and confusing and dated contracting and reimbursement mechanisms. The status quo is increasingly unacceptable to both patients and GPs. There is now a consensus that changes are needed, including to the small-scale independent contractor model, to ensure that primary care can thrive in the future.

Policy Exchange has set out a pragmatic proposal for reform. Addressing issues around integration, workforce, digital transformation and scaled provision, we argue that a new model of general practice is required to better meet the needs of patients and the taxpayer – so it feels increasingly at their service.

Examining the knowledge work of person-centred care: Towards epistemic reciprocity

It is increasingly recognised that when healthcare staff fails to give adequate credence to patients' illness-related knowledge work, this epistemic injustice undermines person-centred care. Therefore, we set out to examine the experiences of people with long-term conditions with knowledge work in healthcare settings to identify changes needed to strengthen person-centred primary care.

Highlights

Family-centred interventions for Indigenous early childhood well-being by primary healthcare services

Primary healthcare, particularly Indigenous-led services, are well placed to deliver services that reflect the needs of Indigenous children and their families. Important characteristics identified by families for primary health care include services that support families, accommodate sociocultural needs, recognise extended family child-rearing practices, and Indigenous ways of knowing and doing business. Indigenous family-centred care interventions have been developed and implemented within primary healthcare services to plan, implement, and support the care of children, immediate and extended family and the home environment. The delivery of family?centred interventions can be through environmental, communication, educational, counselling, and family support approaches.

96th EGPRN meeting

The 96th EGPRN meeting will be held at the University of Split, School of Medicine in Split, Croatia between 11 - 14 May 2023. The theme of this meeting is "Person-centred care and its outcomes in primary care".

Integrated brief interventions for noncommunicable disease risk factors in primary care: the manual: BRIEF project

Brief interventions are recognized by WHO as an effective measure to help people quit tobacco, reduce or stop alcohol use and increase physical activity. They can also help to achieve and maintain healthy eating behaviours and manage weight for those living with overweight and obesity. Brief interventions can translate to significant health benefits at population level when systematically applied to a large proportion of people. The uptake of these interventions in the WHO European Region, however, remains low. This manual is an integral part of the WHO European Office for the Prevention and Control of Noncommunicable Diseases BRIEF project. The manual provides a guide to implementing brief intervention programmes in primary care settings, highlighting facilitators and barriers to implementation. It emphasizes an integrated approach to brief interventions, dealing with all four main behavioural risk factors – tobacco use, alcohol use, unhealthy eating and physical inactivity – and the physiological risk factor of ...

Adaptation and validation of the Ugandan Primary Care Assessment Tool

Construct Validation of the Rainbow Model of Integrated Care Measurement Tool in Dutch Primary Care for Older Adults

are integration in primary elderly care is suboptimal. Validated instruments are needed to enable the implementation of integrated primary care. We aimed to assess construct validity of the Rainbow Model of Integrated Care measurement tool (RMIC-MT) for healthcare professionals working in an integrated primary elderly care setting in the Netherlands.

Editorial: Why changes in primary care will affect integrated care

More and more emphasis in health service integration is placed on the role of primary care. What it means to have a “family doctor” may have changed over the last decades, but its key function of assessing, referring and treating patients remains the bedrock of our health systems. Or does it?

Effects of Virtual Care and Same-Day Access to Integrated Care on Specialty Mental Health Engagement in the Veterans Health Administration

In the Veterans Health Administration (VA), Primary Care-Mental Health Integration (PC-MHI) clinics offer mental health services embedded in primary care, a strategy shown to reduce overall specialty mental health clinic burden while facilitating prompt referrals when indicated. Among newly initiated patients, same-day access to PC-MHI from primary care increases subsequent specialty mental health engagement. However, the impact of virtual care on the association between same-day access to PC-MHI and subsequent mental health engagement remains unclear.

Development of a Person-Centred Integrated Care Approach for Chronic Disease Management in Dutch Primary Care: A Mixed-Method Study

To reduce the burden of chronic diseases on society and individuals, European countries implemented chronic Disease Management Programs (DMPs) that focus on the management of a single chronic disease. However, due to the fact that the scientific evidence that DMPs reduce the burden of chronic diseases is not convincing, patients with multimorbidity may receive overlapping or conflicting treatment advice, and a single disease approach may be conflicting with the core competencies of primary care. In addition, in the Netherlands, care is shifting from DMPs to person-centred integrated care (PC-IC) approaches.

Regional technical meeting on integrated care delivery

This report summarizes the discussion that took place during the Regional technical meeting on integrated care delivery. It represents a continuation of the discussion held as part of the Regional technical meeting on strengthening the integrated delivery of long-term care in the European region, in December 2021, bringing an expanded focus on integration as a transversal issue for health and long-term care systems and an important stepping stone for achieving universal health coverage. Participants discussed and shared evidence and lessons learned on the principles, the practice, the enablers and on-going challenges to improving coordination within and across health and long-term care systems, with particular attention to integration of primary care and community-based long-term care services.

Primary healthcare competencies needed in the management of person-centred integrated care for chronic illness and multimorbidity: Results of a scoping review

Chronic disease management is important in primary care. Disease management programmes focus primarily on the respective diseases. The occurrence of multimorbidity and social problems is addressed to a limited extent. Person-centred integrated care (PC-IC) is an alternative approach, putting the patient at the centre of care. This asks for additional competencies for healthcare professionals involved in the execution of PC-IC. In this scoping review we researched which competencies are necessary for healthcare professionals working in collaborative teams where the focus lies within the concept of PC-IC. We also explored how these competencies can be acquired.

Primary Care for Everyone: An Urgent To-Do List for Reform

Worldwide, the health systems with the best outcomes are the ones that get primary care right. Canada’s federal, provincial and territorial governments are recognizing the critical importance of improving primary care in their recent funding agreements.

The time for bold action is now. New federal funding is entering the system as bilateral agreements are being signed with provinces and territories. “Family health” is front and centre, with all levels of government and people across the country on the same page. It’s time to supercharge the reform.

The Public Policy Forum’s Taking Back Health Care project is a year-long initiative to assemble and promote the best thinking about actions necessary to address Canada’s health-care crisis. This paper is the second in a series of commentaries that the project is producing. The first paper, Taking Back Health Care: How to Accelerate People-Centred Reform Now, was an overview of ...

Barriers and challenges to integrated care

Integrated care is critical to the successful delivery of modern day health and social care services, however the implementation into practice poses many barriers and challenges. This article seeks to identify these barriers and present methods through which to aim to address and overcome these.

Learning from long COVID: integrated care for multiple long-term conditions

Long COVID is a multisystem condition requiring a range of medical, therapeutic, and psychological inputs. Given the complexity of the illness affecting multiple organ systems, often impacting physical and mental health, individuals can be heavy healthcare users across primary, secondary, and emergency services.

The long COVID clinics commissioned in England have provided an opportunity to innovate within a complex care pathway, bringing multiple providers together to meet needs broader than has been historically possible for many other complex conditions. Designing these new services from a blank page has enabled teams to co-create services with patient groups and work more effectively in an integrated way. Significant benefits have been seen, including skills transference between professions.

Primary care: the sleeping giant of research delivery

A sustainable NHS requires a shift from reactive acute care to proactive ambulatory care, from secondary care to primary care, with a focus on health creation by empowering people and communities. This will require evaluation of transformed models of care to create a new evidence base, which in turn requires a strong primary care research delivery infrastructure.

Clinic for Multimorbidity: An Innovative Approach to Integrate General Practice and Specialized Health Care Services

Caring for patients with multimorbidity in general practice is increasing in amount and complexity. To integrate care for patients with multimorbidity and to support general practitioners (GPs), the Clinic for Multimorbidity (CM) was established in 2012 at Silkeborg Regional Hospital, Denmark. This case study aims to describe the CM and the patients seen in it.

Developing an integrated model of care for vulnerable populations living with non-communicable diseases in Lebanon: an online theory of change workshop

The Syrian crisis, followed by a financial crisis, port explosion, and COVID-19, have put enormous strain on Lebanon’s health system. Syrian refugees and the vulnerable host population have a high burden of Non-communicable Diseases (NCD) morbidity and unmet mental health, psychosocial and rehabilitation needs. The International Committee of the Red Cross (ICRC) recently introduced integrated NCD services within its package of primary care in Lebanon, which includes NCD primary health care, rehabilitation, and mental health and psychosocial support services. We aimed to identify relevant outcomes for people living with NCDs from refugee and host communities in northern Lebanon, as well as to define the processes needed to achieve them through an integrated model of care. Given the complexity of the health system in which the interventions are delivered, and the limited practical guidance on integration, we considered systems thinking to be the most appropriate methodological approach.

Integrated care and the behavioral health primary care provider

Primary care remains the main setting for delivery of psychiatric care. An integrated approach improves the ability of primary care providers (PCPs) to care for complex patients with behavioral health needs. This article describes integrated care and how physician associates/assistants can gain additional training to become behavioral health specialists.

Integrated care in action – primary care. Understanding how integrated care systems are redesigning primary care services

This case study shows how integrated care systems are redesigning primary care services.