Experiencing Integrated Health: Ontarians’ views of health care coordination and communication

Health Quality Ontario (HQO) has published an analysis using data from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults in order to identify, from a patient perspective, how well different parts of health system are working together.

The HQO extracted a sample with the population from Ontario; Ontarians reported similar results as top-ranking countries in some indicators related to coordination of care; about 80% of Ontarians said they received help from their regular physicians to coordinate their care with other providers.

The sample from Ontario population made able to identify some key points where Canadian Health System ...

The Patient-Centered Medical Home’s Impact on Cost and Quality: Annual Review of Evidence, 2014-15

The Patient-Centered Medical Home (PCMH) is a model of primary care that is patient-centred, comprehensive, coordinated, accessible and committed to quality and safety. In the PCMH, the primary care team coordinates care for patients and guides them in their journeys across the health care system.  In February 2016, the Patient-Centered Primary Care Collaborative, a not-for-profit membership organization, published a review titled "The Patient-Centered Medical Home's Impact on Cost and Quality", which provides a summary of PCMH cost and utilisation outcomes in the United States. The review includes peer-reviewed studies, state government evaluations, industry reports and independent federal program evaluations ...

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 ...

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 ...

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 ...

How High-Need Patients Experience the Health Care System in Nine Countries

In this study, high-need patients are defined as those aged 65 and older with at least three chronic conditions or a functional limitation in activities of daily living. The brief analyses data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults to investigate health care use, quality, and experiences among high-need patients in nine countries (Australia, Canada, France, Germany, the Netherlands, Norway, Sweden, Switzerland, and the United States) compared with other older adults. The study found that high-need adults use more health care – especially avoidable Emergency Department visits –, experience more cost-related barriers to care, and poorly coordinated ...

Integrated health systems and cost: accountability and price control are also important.

Integrated Health Services are frequently thought as a tool to decrease healthcare-related costs, specially in systems with a high level of fragmentation. In the US healthcare system reform, Medicare has often been used as a reference point of the overall health expenditure. In this post, this hypothesis is analysed according to a recent article from the National Bureau of Economic Research ("The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured") where the authors review the costs of 306 Hospital Referral Regions in the US, showing a big discordance between Medicare costs and overall costs.

In ...