Patient-Centred Care for Patients With Diabetes and HIV at a Public Tertiary Hospital in South Africa: An Ethnographic Study

Healthcare systems across the globe are adopting patient-centred care (PCC) approach to empower patients in taking charge of their illnesses and improve the quality of care. Although models of patient?centredness vary, respecting the needs and preferences of individuals receiving care is important. South Africa has implemented an integrated chronic disease management (ICDM) which has PCC component. The ICDM aims to empower chronic care patients to play an active role in disease management process, whilst simultaneously intervening at a community/ population and health service level. However, chronic care is still fragmented due to systemic challenges that have hindered the practice ...

Implementation of patient-centred care: which system-level determinants matter from a decision maker’s perspective? Results from a qualitative interview study across various health and social care organisations

The healthcare system is characterised by a high degree of complexity and involves various actors at different institutional levels and in different care contexts. To implement patient-centred care (PCC) successfully, a multidimensional consideration of influencing factors is required. Our qualitative study aims to identify system-level determinants of PCC implementation from the perspective of different health and social care organisations (HSCOs).

The results showed the necessity of enforcing paradigm changes at the system level from disease-centredness to patient-centredness while aligning policy and reimbursement decisions directly with patient needs and values. A systematic, long-term planned strategy that extends across all organisations is ...

Adoption of the concept of person-centred care into discourse in Europe: a systematic literature review

This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket). Our findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation—from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.

Putting patients first: development of a patient advocate and general practitioner-informed model of patient-centred care

Patients, providers and health care organisations benefit from an increased understanding and implementation of patient-centred care (PCC) by general practitioners (GPs). This study aimed to evaluate and advance a theoretical model of PCC developed in consultation with practising GPs and patient advocates.

Navigate Your Health: A Case Study of Organisational Learnings from an Integrated Care Pilot for Children and Young People in Care

Three peak organisations in Queensland, Australia partnered with consumers and other health and social sector partners to co-design and pilot the first known integrated, health navigation model to improve outcomes for children and young people in care in Australia. Findings highlighted the agency partners’ drive to foster a more integrated and person-centred approach to care. The pilot’s aim of improving health outcomes for a vulnerable population were achieved through a co-designed process which provided additional insights regarding partnerships, improvement, scalability and sustainability.

Targeting integrated care to those most likely to need frequent health care: a review of social and clinical risk factors

This rapid review was commissioned by the NSW Agency for Clinical Innovation (ACI) and the Sax Institute in Australia to examine the evidence concerning social and clinical risk factors which may be significant predictors of both pre-hospital and hospital service utilisation. The context is that the NSW Ministry of Health wishes to develop a NSW approach for risk stratification and patient selection that identifies people who are at risk(s) of poorer health outcome(s), and enable targeted delivery of integrated care to those who will maximally benefit.

Integrated care: easy in theory, harder in practice?

Integrated care (IC) is a term now commonly adopted across the world, which implies a positive attitude towards addressing fragmentation of service provision inside health systems. While the principles of IC are simple, their implementation is more controversial. The ever growing number of IC definitions is related to the increasing domains of applications, which reflect the increasing demand induced by ageing multi-morbid patients. An exhaustive definition of IC should now enclose the coordination of health and social services useful to deliver seamless care across organizational boundaries. The current debate on IC is largely fueled by the modern mismatch between the ...

Integrated Care in Europe: Time to Get it Together?

What are the priorities for the future development of integrated care? A scoping review

“Integrated care” (IC) is an approach to health and social care delivery that aims to prevent problems arising from fragmented care systems. The collective content of the IC literature, whilst valuable, has become extensive and wide-ranging to such a degree that knowing what is most important in IC is a challenge. This study aims to address this issue.

Measurement-based care in integrated health care: A randomized clinical trial

Many suggest that the next step for integrated care is widespread implementation of measurement-based care (MBC). Although the measures most associated with MBC are standardized, no randomized clinical trial has demonstrated their use to improve psychotherapeutic outcomes with embedded behavioral health providers in integrated care. Two evidence-based MBC systems have been studied in a variety of behavioral health environments, but neither system has been investigated in integrated health care. Addressing this gap in the literature, the present study evaluated the use of MBC, specifically the Partners for Change Outcome Management System, in three integrated care sites.