Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators

With an ageing population there is a move towards the use of assisted living technologies (ALTs) to provide social care and health care services, and to improve service processes. These technologies are at the forefront of the integration of health and social care. However, economic evaluatios of ALTs, and indeed economic evaluations of any interventions providing both health benefits and benefits beyond health are complex. This paper considers the challenges faced by evaluators and presents a method of economic evaluation for use with interventions where traditional methods may not be suitable for informing funders and decision makers. They propose a ...

What can a participatory approach to evaluation contribute to the field of integrated care?

Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground.

We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits ...

Integrated care for patients and populations: Improving outcomes by working together

This report examines:

- The case for integrated care

- What current barriers to integrated care need to be overcome and how

- What the Department of Health can do to provide a supporting framework to enable integrated care to flourish

- Options for a practical and technical support to those implementing integrated care, including approaches to evaluatin its impact 

The report asserts that developing integrated care should assume the same priority over the nect decade as reducing waiting times had during the last. The report makes a constructive contribution to the debate about integrated care and will be of interest to policy-makers, health ...

From vision to action. Making patient-centred care a reality

The NHS have worked with The King´s Fund to translate their themes into outcomes for patients and set out the most important priorities for action to achieve these outcomes. Under each of their five themes: 

- Co-ordinated care

- Patients engaged decisions about their care

- Supported self-management

- Prevention, early diagnosis and intervention

- Emotional, psychological and practical support

they have described the outcomes that they most want to achieve for patients. In order to achieve these outcomes, they hace then selected the service improvements that, if met, will have a major impact on the quality and cost-effectiveness of care. 

Understanding the role of community hospitals: an analysis of experiences in five countries

A policy focus on moving heathcare closer to people´s homes has led to renewed interest in community hospitals and their potential role in delivering more integrated care at local level, but models and approaches differ across countries. 

This study explores the policy drivers behind the implementation or advancement of these models; their function and role within the wider system of service provision; and the degree to which community hospitals contribute to enhanced integration of service delivery and benefit the population. 

Integrating palliative care into primary care for patients with chronic, life-limiting conditions.

As longevity increases, individuals with chronic, life-limiting conditions will live longer with disease burden and functional decline. Nurse practitioners can integrate symptom management, early decision-making, and supportive care into the primary care setting to improve quality of life and decrease economic and emotional impact at the end of life.

Association of Integrated Team-Based Care With Health Care Quality, Utilization, and Cost

The value of integrated team delivery models is not firmly established. So we evaluate the association of receiving primary care in integrated team-based care (TBC) practices vs traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs.

Conclusions: Among adults enrolled in an integrated health care system, receipt of primary care at TBC practices compared with TPM practices was associated with higher rates of some measures of quality of care, lower rates for some measures of acute care utilization, and lower actual payments received by the delivery system.

The Value of Continuity between Primary Care and Surgical Care in Colon Cancer

Improving continuity between primary care and cancer care is critical for improving cancer outcomes and curbing cancer costs. A dimension of continuity, we investigated how regularly patients receive their primary care and surgical care for colon cancer from the same hospital and whether this affects mortality and costs.Receiving primary care and surgical care at the same hospital, compared to different hospitals, was associated with lower costs but still similar survival among stage I-III colon cancer patients. Nonetheless, health care policy which encourages further integration between primary care and cancer care in order to improve outcomes and decrease costs will ...

Meeting the Needs of the Growing Very Old Population: Policy Implications for a Global Challenge

Very old adults are one of the fastest-growing age groups worldwide. Yet they rarely constitute a targeted group for public policies. Drawing on the results of the centenarian studies presented in this special issue, we highlight major challenges that arise from the increase of this population. We outline several promising approaches for policy makers and professionals to develop evidence-based policies and programs that are tailored to the needs of very old adults and their families. We focus our discussion on three key topics essential to life care: the importance of integrated care to meet the complex care needs of the ...

Understanding integrated care: a complex process, a fundamental principle

Recent Editorial in the International Journal on Integrated Care, written by Nick Goodwin, emphasising the importance of the Framework. Around the past year Nick Goodwin has been involved in a range of research and development activities that seek to understand and/or promote the successful adoption of integrated care. In each of these, a common opening statement from protagonists is to typically say that “there is no universally accepted definition of integrated care, no one model of care that can be replicated locally, and little evidence to tell us that it works”. Whilst the latter might be disputed it remains ...