Patient centred care for multimorbidity improves patient experience, but quality of life is unchanged

The UK has an ageing population. A 2018 study of multimorbidity in England found that 54% of people over 65 had multimorbidity in 2015. This is expected to rise to 68% by 2035, with 17% of people over 65 expected to have four or more conditions. National guidelines tend to focus on single conditions. People with multimorbidity may have their conditions managed individually without due consideration of the overall burden of their diseases and treatments. Recognition of this prompted the National Institute for Health and Care Excellence (NICE) and other international organisations to develop guidelines on managing multimorbidity. These focus ...

Integrated Care Regulation, Assessment, and Inspection – A Collaborative Learning Journey

Over the past ten years, the design and implementation of integrated health and social care organisations and systems has occurred across several continents. These models of care have implied the adoption of new approaches to their organization and governance. As a result, many countries have begun to focus specifically on the regulation, assessment and inspection of integrated care. This editorial argues that there is both an opportunity and a need to share the successes and challenges from these experiences and to promote methods for collaborative learning.

Continuity of care and referral rate: challenges for the future of health care

As health care costs rise, an increasingly greater proportion of the gross domestic product is spent on health care. In this context, Continuity of care could reduce health care consumption by patients and reduce the number of referrals to specialist care, but it is unknown if there is a difference in referral rates to specific medical specialties.

The aim of this study was to determine the relationship between continuity of care and both the referral rate (referrals per patient per year) and the medical specialties for which this relationship was strongest.

Public health law coverage in support of the health-related sustainable development goals (SDGs) among 33 Western Pacific countries

A resilient health system is inevitable in attaining the health-related Sustainable Development Goals (SDGs). One way of strengthening health systems is improving the coverage of public health laws for better health governance. The aim of this study is to describe the public health law situation in the Western Pacific Region and analyse the association of public health law coverage with health-related SDGs statistics.

Community health extension program of Ethiopia, 2003–2018: successes and challenges toward universal coverage for primary healthcare services

The Alma-Ata Declaration of 1978 identified primary health care (PHC) as the key approach to the attainment of the goal of “Health for All”. The PHC approach tackles the main health problems in the community through the provision of essential health services. The implementation of the PHC approach relies on health workers, including community health workers (CHWs) Ethiopia has been implementing a community health extension program (HEP) since 2003. The aim of this studya was to assess the successes and challenges of the HEP over time, and develop a framework that may assist the implementation of the program toward universal ...

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.

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.

Measuring patient-centred system performance: a scoping review of patient-centred care quality indicators

Patient-centred care (PCC) is one of the six dimensions of healthcare and was formally described by the Institute of Medicine in 2001 as healthcare that respects and responds to the preferences, needs and values of the individual patients throughout all healthcare decisions. PCC is an approach that has become central to policies and programming to improve healthcare efficiencies and address patient safety issues.
In that sense, The shift to the patient-centred care (PCC) model as a healthcare delivery paradigm calls for systematic measurement and evaluation. In an attempt to develop patient-centred quality indicators (PC-QIs), this study aimed to identify quality ...

Health literacy as a social practice: Social and empirical dimensions of knowledge on health and healthcare

Health literacy has become a hot topic in health research and public health promotion. Most definitions specify health literacy as an individual cognitive skill, and surveys such as the EU-HLS which ask people to self-rate their decision-making capacity in the health system, grade a majority of the population as having an inadequate health literacy. Inspired by a praxeological understanding of knowledge and based on an empirical study on welfare bricolage in superdiverse urban neighborhoods, this paper explores health literacy ethnographically and highlights people's knowledge, creative practices and experiences concerning health and healthcare.

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.