Integrated care: better and cheaper

Integrated care improves health, increases quality of care and lowers costs. These three goals, this Triple Aim in other words, are achieved in many examples from all over the world: from Alaska to New Zealand, from Western Europe to South Africa. However, disseminating all these good examples is easier said than done, as nationwide implementation means the simultaneous realisation of the following six components of integrated care:

1. Multidisciplinary care pathways and decision trees

2. Patient self-management and shared decision-making by patients and professionals

3. Guaranteeing professional and patient- perceived quality

4. Population-based funding and shared savings

5. An Electronic Health Record and e-health

6. Servant leadership and a strategy for change management.

These are the conclusions Guus Schrijvers draws in his book Integrated Care: better and cheaper. His conclusions are based on more than 500 studies from the 1960s until mid-2016. In addition, he also draws on his own ...

A Critical Analysis of Purchasing Arrangements in Kenya: The Case of the National Hospital Insurance Fund

Purchasing refers to the process by which pooled funds are paid to providers in order to deliver a set of health care interventions. Very little is known about purchasing arrangements in low-and middle- income countries, and certainly not in Kenya. This study aimed to critically analyse purchasing arrangements in Kenya, using the National Hospitals Insurance Fund as a case study. 

Health Services Research Spending and Healthcare System Impact

The challenges associated with translating health services and policy research evidence into practice are many and long-standing. Indeed, those challenges have themselves spawned new areas of research, including knowledge translation and implementation science. These sub-disciplines have increase our understanding of the critical success factors associated with the uptake of research evidence into (system) practice. In that regard, building on Canada´s recent Strategy for Patient Oriented Research would seem to offer consideravle promise. The "modest" proposals offered by Thakkar and Sulivan seem less likely to bear fruit. 

The context, strategy and performance of the American safety net primary care providers: a systematic review

The objective of this research is to synthesize evidence on the relationship between context, strategies and performance in the context of federally qualified health centers (FQHCs), a core safety net health services provider in the United States. The research also identifies prior approaches to measure contextual factors, FQHC strategy and performance. Gaps in the research are identified, and directions for future research are provided.