From People-Centred to People-Driven Care: Can Integrated Care Achieve its Promise without it?

In this editorial, we argue that people-centred care has often remained too passive, condemns patients and carers to subservient roles, and as a result preserves a power imbalance that favours systems and professionals over people and communities. For integrated care to reach its full potential, we instead advocate for a deliberate shift towards ‘people-driven’ care where people have more agency in participating in their health and greater power in decision-making.

Reimagining Primary Health Care Workforce in Rural and Underserved Settings

This Discussion Paper starts at the local level and reimagines primary health care (PHC) and the PHC workforce from the perspective of people living in rural and underserved urban areas of low- and middle-income countries (LMICs). Drawing on research evidence and successful examples, it presents a “start local” health service delivery model, health system design framework, and financing models intended to ensure high-quality local comprehensive PHC is available and accessible to all. Core PHC team members (community health workers, registered nurses, specialist family physicians, and administrators) and other health practitioners are generalists in their disciplines, working together in collaborative practice ...

Decision-Making Dilemmas within Integrated Care Service Networks: A Systematic Literature Review

The diverse nature of people’s care needs requires collaboration between different organisations and sectors. One way of achieving such collaboration is through integrated care service networks. Decision-making is considered an important aspect of network governance and key to achieve further integration of care services. As integrated care scholars only implicitly seem to touch upon the issue of decision-making, we aimed to identify multiple decision-making dilemmas.

WHO guide for integration of perinatal mental health in maternal and child health services

Overview

Supporting good mental health can improve health outcomes, and the quality of maternal and child health services for all women can be improved by creating an environment where they feel safe to discuss any difficulties they are experiencing in a respectful and caring environment that is free from stigmatization. 

The guide for integration of perinatal mental health in maternal and child health services outlines an evidence-informed approach describing how program managers, health service administrators and policy-makers responsible of planning and managing maternal and child health services can develop and sustain high-quality, integrated mental health services for women during the ...

International comparisons of the quality and outcomes of integrated care: Findings of the OECD pilot on stroke and chronic heart failure

Across OECD countries, two in three people aged over 65 years live with at least one chronic condition often requiring multiple interactions with different providers, making them more susceptible to poor and fragmented care. This has prompted calls for making health systems more people-centred, capable of delivering high-quality integrated care. Despite promising, mostly local-level, experiences, systems remain fragmented, focused on acute care and unsuitable to solve complex needs. Moreover, assessing and comparing the benefits of integrated care remains difficult given the lack of technically sound, policy-relevant indicators. This report presents the results of the first OECD pilot of a new ...

Social workers coordination in primary healthcare for patients with complex needs: A scoping review

Care coordination has been part of social work for some time. It has been recognized as contributing to care coordination for long-term care for the elderly and mental health but less is known about their contribution in primary care with patients with complex health and social needs. As social workers are increasingly present in primary healthcare, this scoping review aims to provide a synthesis of social workers’ coordination activities for patients with complex needs in primary healthcare.

All together now – patient engagement, patient empowerment, and associated terms in personal healthcare

Patients as active partners in their personal healthcare are key drivers to reducing costs, securing an effective usage of resources, and ensuring patient-provider satisfaction. Even though these benefits are acknowledged, a theoretical framework for the plethora of concepts used in this context, such as patient engagement, patient empowerment, or patient involvement is missing. Furthermore, the heterogeneous or synonymous usage of these terms leads to miscommunication, missing standard conceptual measures, and a deficiency in theory building and testing. Our objective is to show what the relationships and distinctions between concepts focussing on patients as active partners in their personal healthcare are.

Ending tuberculosis in a post-COVID-19 world: a person-centred, equity-oriented approach

The COVID-19 pandemic has disrupted systems of care for infectious diseases—including tuberculosis—and has exposed pervasive inequities that have long marred efforts to combat these diseases. The resulting health disparities often intersect at the individual and community levels in ways that heighten vulnerability to tuberculosis. Effective responses to tuberculosis (and other infectious diseases) must respond to these realities. Unfortunately, current tuberculosis programmes are generally not designed from the perspectives of affected individuals and fail to address structural determinants of health disparities. We describe a person-centred, equity-oriented response that would identify and focus on communities affected by disparities, tailor interventions ...

Asynchronous Remote Communication as a Tool for Care Management in Primary Care: A Rapid Review of the Literature

To review the available evidence on asynchronous communication models between primary care professionals and patients in different countries around the world in order to analyse the added value that this model brings to patients and professionals.

Person-centred care in primary care: What works for whom, how and in what circumstances?

This rapid realist review aims to explain how and why person-centred care (PCC) in primary care works (or not) among others for people with low health literacy skills and for people with a diverse ethnic and socioeconomic background, and to construct a middle-range programme theory (PT). The middle-range PT demonstrates that healthcare professionals (HCPs) should be trained and equipped with the knowledge and skills to communicate effectively (i.e. in easy-to-understand words, emphatically, checking whether the patient understands everything, listening attentively) tailored to the wishes, needs and possibilities of the patient, which may lead to higher satisfaction.