Political struggles for a universal health system in Brazil: successes and limits in the reduction of inequalities

Brazil is a populous high/middle-income country, characterized by deep economic and social inequalities. Like most other Latin American nations, Brazil constructed a health system that included, on the one hand, public health programs and, on the other, social insurance healthcare for those working in the formal sector. This study analyzes the political struggles surrounding the implementation of a universal health system from the mid-1980s to the present, and their effects on selected health indicators, focusing on the relevant international and national contexts, political agendas, government orientations and actors.

Association of the Implementation of the Patient-Centered Medical Home with Quality of Life in Patients with Multimorbidity

The patient-centered medical home (PCMH) has clinical benefits for chronic disease care, but the association with patient-reported outcomes such as health-related quality of life (HRQoL) is unexplored in patients with multimorbidity (two or more chronic diseases). The aim o this study was to examine if greater clinic-level PCMH implementation was associated with higher HRQoL in multimorbid adults.

Should community pharmacy be 'linked'? The perceptions of including community pharmacy in an integrated care model in Ontario, Canada

Integrated care models are becoming more frequent in various health systems to provide quality coordinated care, with the aim of improving patient outcomes and costs. Many patients under an integrated care model present with complex health and social needs requiring more sophisticated care coordination. 

Multiple Perspectives Analysis of the Implementation of an Integrated Care Model for Older Adults in Quebec

Integrated care models for older adults are increasingly utilised in healthcare systems to overcome fragmentations. Several groups of stakeholders are involved in the implementation of integrated care. The aim of this study is to identify the main concerns, convergences and divergences in perspectives of stakeholders involved in the implementation of a centralised system-wide integrated care model for older adults in Quebec.

Integrated care workforce development: university-community collaboration

Behavioral health workforce shortages to provide quality care services for children, adolescents, and transitional age youth are well established. This paper highlights the workforce shortage and the need to infuse interprofessional education to engage in integrated care for children, adolescents and transitional age youth with behavioral health needs. 

Patients’ perspectives on integrated oral healthcare in a northern Quebec Indigenous primary health care organisation: a qualitative study

Patient-centred care is considered to be an important element in the evaluation of integrated healthcare and has been effective in addressing oral health disparities. This study explored the patients’ perspectives of patient-centred integrated care in oral health services integrated into a primary healthcare organisation serving a northern Quebec Cree population.

Development and Testing of the Provider and Staff Perceptions of Integrated Care (PSPIC) Survey

This article discusses development and testing of the Provider and Staff Perceptions of Integrated Care Survey, a 21-item questionnaire, informed by Singer and colleagues’ seven-construct framework. Questionnaires were sent to 2,936 providers and staff at 100 federally qualified health centers and other safety net clinics in 10 Midwestern U.S. states. Item analyses, exploratory factor analysis, and confirmatory factor analysis were undertaken.

What is Important to Older People with Multimorbidity and Their Caregivers? Identifying Attributes of Person Centered Care from the User Perspective

Health systems are striving to design and deliver care that is ‘person centered’—aligned with the needs and preferences of those receiving it; however, it is unclear what older people and their caregivers value in their care. This paper captures attributes of care that are important to older people and their caregivers.

Impact of health care reform on enrolment of immigrants in primary care in Ontario, Canada

Health is driven by the conditions in which people live and work. Immigrant populations face many challenges and disruptions in living conditions during their settlement process, including the loss of regular health services. Establishing a direct relationship with a family physician is an important aspect of the settlement process for immigrant populations

In 2003, Ontario introduced a patient enrolment system as part of health care reforms, aimed at enhancing primary health care services, but it is unclear whether immigrants have benefited from this health care reform. Therefore, this article studied whether this reform changed the extent of immigrants’ enrolment in ...

Patient–Provider Video Telemedicine Integrated With Clinical Care: Patient Experiences

Real-time patient–provider video visits have the potential to engage patients by allowing them to access a clinical encounter without arranging transportation, taking time off from work, or spending time in a waiting room. Although millions of U.S. patients have used direct-to-consumer telemedicine services without in-person facilities, these services may lack integration with electronic health records and with clinicians from whom patients receive ongoing care. Evidence is limited from large-scale implementation of “house call” video visits integrated with ongoing health care delivery and providers in community primary care.