Integrated Care for Multimorbidity Population in Asian Countries: A Scoping Review

The complex needs of patients with multiple chronic diseases call for integrated care (IC). This scoping review examines several published Asian IC programmes and their relevant components and elements in managing multimorbidity patients. In the IC programmes for patients with multimorbidity in Asia, service delivery, leadership, and workforce were most frequently mentioned, while the financing component was least mentioned.

Inequalities in Older age and Primary Health Care Utilization in Low- and Middle-Income Countries: A Systematic Review

The objective of this research was to systematically review and synthesize quantitative studies that assessed the association between socioeconomic inequalities and primary health care (PHC) utilization among older people living in low- and middle- income countries (LMICs). Most studies reported that higher income, higher educational levels and enrollment in health insurance plans were associated with increased PHC utilization. Several studies suggested that people who were unemployed and economically inactive in older age or who had worked in formal sectors were more likely to use PHC. Our findings suggest a pro-rich phenomenon of PHC utilization in older people living in LMICs ...

A mixed-method study on the provision of remote consultations for non-communicable disease patients during the first wave of the COVID-19 pandemic in Latvia: lessons for the future

he COVID-19 pandemic has challenged the ability of healthcare systems to ensure the continuity of health services for patients with non-communicable diseases (NCDs). The issue of remote consultations has emerged. Before the COVID-19 pandemic, remote consultations were not routinely provided or covered by public health funding in Latvia. This study aimed to describe the dynamics of consultations and the volume of remote consultations provided for patients with particular NCD and explore clinicians’ experiences of providing remote consultations during the first wave of the COVID-19 pandemic in Latvia.

Modified scoping review of the enablers and barriers to implementing primary health care in the COVID-19 context

Since the Alma Ata Declaration of 1978, countries have varied in their progress towards establishing and sustaining comprehensive primary health care (PHC) and realizing its associated vision of 'Health for All'. International health emergencies such as the coronavirus-19 (COVID-19) pandemic underscore the importance of PHC in underpinning health equity, including via access to routine essential services and emergency responsiveness. This review synthesizes the current state of knowledge about PHC impacts, implementation enablers and barriers, and knowledge gaps across the three main PHC components as conceptualized in the 2018 Astana Framework.

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

The Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria. This project adapted the World Health Organization’s Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG), emphasizing stigma reduction among trainees. This convergent mixed-methods proof-of-concept study evaluates the HAPPINESS pilot project mhGAP-IG training’s impact on mental illness stigma among trainees and barriers, facilitators, and opportunities to consider for project improvement.

The European Health Data Space: A step towards digital and integrated care systems

In December 2021, EGIDE, the Expert Group for integrated Care and Digital Health Europe, has launched a paper ‘The European Health Data Space: A step towards digital and integrated care systems’.

The paper aims to represent the views of the chronic disease community. It provides a unique combination of perspectives from academia, healthcare professionals, patients and industry. The authors acknowledge too many patients across Europe are experiencing fragmented and delayed care. COVID-19 has highlighted the weaknesses of our healthcare systems and the need for rapid transformation. The European Health Data Space can act as a catalyst for change in several ...

Strengthening primary health care: contributions of young professional-led communities of practice

Health systems that have strong primary health care at their core have overall better patient outcomes. Primary health care is key to achieving Universal Health Coverage and the broader health-related Sustainable Development Goals by 2030. In 2018, at the launch of the Declaration of Astana, the World Health Organization formed the inaugural Primary Health Care Young Leaders’ Network. This paper aims to demonstrate the scope for young professional-led communities of practice in fostering support systems for young leaders and strengthening the delivery of primary health care at multiple levels.

What matters most in acute care: an interview study with older people living with frailty

Healthcare outcome goals are central to person-centred acute care, however evidence among older people is scarce. Older people who are living with frailty have distinct requirements for healthcare delivery and have distinct risk for adverse outcomes from healthcare. There is insufficient evidence for whether those living with frailty also have distinct healthcare outcome goals. This study explored the nature of acute care outcome goals in people living with frailty.

Community-Based Integrated Care Units: Intermediate Care Units for Older Adults in Japan

Demographic changes caused by the global aging of the population are leading to increased medical and care costs. Several models of care that avoid admission to general acute care hospitals, increased medical costs, and poor outcomes after hospitalization are being explored. Ribbink et al. reported on the subacute care unit (SCU) in Spain and the acute geriatric care hospital (AGCH) in the Netherlands as intermediate care units that provided an alternative to admission to a general hospital. In the present letter, we introduce the characteristics and outcomes of community-based integrated care units (CICUs) in Japan, which function as intermediate care ...

Community Volunteers and Primary Care Providers Supporting Older Adults in System Navigation: A Mixed Methods Study

Primary care providers and community volunteers have important roles in supporting patient system navigation and utilization of community-based health and social services (CBHSS). This study aimed to explore the experiences and impacts of system navigation in a complex intervention supporting older adults. Primary care teams’ practice of system navigation was impacted by programme participation, including through learning about local CBHSS.