March 18, 2016 Americas Global

Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses

Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a “diagonal approach.” We ...

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March 18, 2016 Americas

Primary Care and Public Health Services Integration in Brazil’s Unified Health System

Objectives: We examined associations between transdisciplinary collaboration, evidence-based practice, and primary care and public health services integration in Brazil’s Family Health Strategy. We aimed to identify practices that facilitate service integration and evidence-based practice.

Methods: We collected cross-sectional data from community health workers, nurses, and physicians (n = 262). We used structural equation modeling to assess providers’ service integration and evidence-based practice engagement operationalized as latent factors. Predictors included endorsement of team meetings, access to and consultations with colleagues, familiarity with community, and previous research experience.

Results: Providers’ familiarity with community and team meetings positively influenced evidence-based practice engagement and ...

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March 17, 2016 Americas

Health-system reform and universal health coverage in Latin America

Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions ...

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March 16, 2016 Global

Five principles behind the world’s most efficient health systems

Efficiency is said to be one of the main characteristics of sustainable health systems. In this article posted in Nuffield Trust’s Blog some of the key points that drive health systems towards efficiency are described: 1) integrated pharmacy, community and primary care; 2) hospitals as health systems; 3) standardize, simplify through IT, then shift the skill mix; 4) political courage, take social care seriously; 5) a dominant payer deliver a better health, care and value.

In this article, integrated care is mentioned not only as a health care issue, but also as a way of giving social care the ...

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March 16, 2016 Europe

ENS4Care: Evidence Based Guidelines for Nurses and Social Care Workers for the deployment of eHealth services

The EU-funded Ens4Care project has developed five guidelines for European nurses and social workers on how to use eHealth for promoting a healthy lifestyle and prevention, clinical practice, skills development for advanced roles, integrated care and nurse ePrescribing. 

The 2-year-project, that was launched in December 2013, funded by the EU and coordinated by the European Federation of Nurses Associations (EFN) together with 24 partners from all over Europe, including a mix of different professional associations in nursing and social care, nursing regulators and unions, informal carers, patients, researchers and research communities, civil society representatives and industry. They have collected a ...

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March 16, 2016 Europe

Bringing together physical and mental health: A new frontier for integrated care

In March 2016, the King’s Fund published a compelling case for this ‘new frontier’ for integration:physical and mental health. It gives service users’ perspectives on what integrated care would look like and highlights 10 areas that offer some of the biggest opportunities for improving the quality and controlling costs: 

1. Incorporating mental health into public health programmes
2. Promoting health among people with severe mental illnesses
3. Improving management of medically unexplained symptoms in primary care
4. Strengthening primary care for the physical health needs of people with severe mental illnesses
5. Supporting the mental health of people with long-term conditions
6. Supporting the ...

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March 15, 2016 Global

Developing a Framework for Evaluating the Patient Engagement, Quality, and Safety of Mobile Health Applications

Rising ownership of smartphones and tablets across social and demographic groups has made mobile applications, or apps, a potentially promising tool for engaging patients in their health care, particularly those with high health care needs. Through a systematic search of iOS (Apple) and Android app stores and an analysis of apps targeting individuals with chronic illnesses, this issue brief assesses the degree to which apps are likely to be useful in patient engagement efforts. Usefulness was determined based on the following criteria: description of engagement, relevance to the targeted patient population, consumer ratings and reviews, and most recent app update ...

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March 14, 2016 Europe

Improving the Delivery of Adult Diabetes Care Through Integration: Sharing Experience and Learning

In October 2014 the charity Diabetes UK published a report titled "Improving the Delivery of Adult Diabetes Care Through Integration: Sharing Experience and Learning".  The report identifies five key enablers for integrated care and outlines specific local initiatives in the UK which deliver integrated care for patients with diabetes. For example, the Royal Wolverhampton Hospitals NHS Trust (which delivers community and hospital services in Wolverhampton) along with the local Clinical Commissioning Group and various GP practices have been involved in an integrated and patient-centred model of diabetes care for many years. The model is characterised by partnerships between primary and ...

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March 3, 2016 Europe

The Right Medicine: Improving Care in Care Homes.

The increase of polypharmacy together with the population aging is making care homes a central point to develop health care programmes, specially related to medicines management and integration of different health care proffessionals.

The Royal Pharmaceutical Society has recently published a report addressing the main issues of medicine use in care homes. The needs identified by the authors include developing better communication systems, reducing falls in care homes, decreasing inappropriate use of psychotropic medicines, improving coordinated end of life care and lowering waste of medicines at home.

The report includes some recommendations such as giving pharmacists a major role in ...

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March 3, 2016 Americas

The patient-as-partner approach in health care: a conceptual framework for a necessary transition.

A new model to enforce the partnership between patients and healthcare professionals has been developed at the University of Montreal’s Faculty of Medicine. Their patient-as-partner approach is rooted in patient-centered perspectives that have inspired previous initiatives like shared decision making, therapeutic education, expert patient and self-management. The main contribution of “Montreal model” is to consider the patient as a caregiver of himself and, as such, a genuine member of the treatment team, endowed with competencies and limitations just like any other member of the team.
This article describes the theoretical basis and summarize the main achievements of this innovative ...

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