The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization

The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization reviews PCMH results from 45 peer-reviewed reports and additional government and state evaluations. Implementation of the PCMH and high performing primary care differs depending upon the needs and preferences of those delivering, receiving, and paying for related care. 

The sixth annual PCPCC report, authored by the Robert Graham Center of the American Academy of Family Physicians and published with support from the Milbank Memorial Fund, employed broader search terms and more rigorous search criteria that evaluated studies, reports, and evaluations published between November 1, 2015 to February 28 ...

The SELFIE framework for integrated care for multi-morbidity: Development and description

The rise of multi-morbidity constitutes a serious challenge in health and social care organisation that requires a shift from disease-towards person-centred integrated care. The aim of the current study was to develop a conceptual framework that can aid the development, implementation, description, and evaluation of integrated care programmes for multi-morbidity. The framework structures relevant concepts in integrated care for multimorbidity and can be applied by different stakeholders to guide development, implementation, description, and evaluation. 

Integrating Social Services and Home-Based Primary Care for High-Risk Patients

There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centred care and integration of health care with social services are the cornerstones of a more humane and efficient system. In the hope of stimulating further discussion and debate, the authors summarize existing viewpoints on how a home-centered system, which integrates social and medical services, might emerge in the next few years. 

The role of organizational structure in readiness for change: A conceptual integration

The purpose of this review is to extend extant conceptualizations of readiness for change as an individual-level phenomenon. This review-of-reviews focuses on existing conceptual frameworks from the dissemination, implementation, quality improvement, and organizational trasformation literatures in order to integrate theoretical rationales for how organization structure, a key dimension of the organizational context, may impact readiness for change. They propose that the organization structure dimensions of differentiation and integration impact readiness for change at the indicidual level of analysis by influencing four key concepts of relevance, legitimacy, preceived need for change, and resource allocation. 

Understanding and Evaluating the Implementation on Integrated Care: A "Three Pipe Problem"

Altought we have come a long way in being able to articulate the key building blocks of integrated care, the interplay between them is so complex and interwined that it seems an impossible challenge to create any simple implementation model. Yet, if integrated care is to advance, we must become better at smoothing over the many obstacles and challenges to implementation that have bedevilled the uptake and roll-out of even the most proven of integrated care interventions.

This is quite the "three-pipe problem" for integrated care since science has yet to make the real breakthrough to address how we might ...

Integrated Care: A Pill for All Ills?

There is an increasing policy emphasis on the integration of care, both within the healthcare sector and also between the health and social care sectors, with the simple aim of ensuring that individuals get the right care, in the right place, at the right time. However, implementin this simple aim si rather more complex. In this editorial, they seek to make sense of this complexity and ask: what does integrated care mean in practice? What are the mechanims by which it is expected to achieve its aim? And what is the nature of the evidence base around the outcomes delivered?

The Digital House of Care: Information solutions for integrated care

This paper draws on the recent experience of achieving large-scale data integration accross the boundaries of health and social care, to help plan and commission services more effectively. The purpose is to describe the development of a digital tool in an English county stiving towards a vision of integrated information that is used to underpin and increasingly integrated future of health and social care delivery. 

Integrated Diabetes Care: A Multidisciplinary Approach

Integrated care is an approach that seeks to improve the quality of care for people with diabetes by ensuring that services are well coordinated around their needs. Healthcare professionals, people with diabetes and the system must be aligned to support improvement both in the delivery of care and in achieving better outcomes for people with diabetes.

People-centred integration in a refugee primary care service: A complex adaptive systems perspective

Services for refugees and asylum seekers frequently experience gaps in delivery and access, poor coordination, and service stress. The purpose of this paper is to examine the approach to integrated care within Companion House (CH), a refugee primary care service, whose service mix includes counselling, medical care, community development, and advocacy. CH has created fluid links between teams, and encouraged open dialogue with client populations. There is a high level of networking between staff, much of it informal. This is underpinned by horizontal management and staff commitment to a shared mission and an ethos of mutual respect. The clinical teams ...

Intruments measuring integrated care: A systematic review of measurement properties

Integrated care is an important strategy for increasing health system preformance. Despite its growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague an limited. This systematic review found 209 index instruments measuring different constructs related to integrated care which suggest that the quality of measurement properties of instruments measuring integrate care is in need of improvement with the less-studied constructs and domains to become part of newly developed instruments.