Impact of Proactive Integrated Care on Chronic Obstructive Pulmonary Disease

In the United States, chronic obstructive pulmonary disease (COPD) affects over 16 million people, costs $32 billion per year, and is the fourth leading cause of death.Exacerbations of COPD are among the most devastating complications of COPD, because they greatly increase the risk of death and account for 60% of COPD costs.Efforts have focused on standardizing recommendations for therapies that improve symptoms and limit exacerbations, identifying patients who might benefit from these treatments, and increasing compliance with recommended therapies.Surprisingly, only about 50% of COPD patients receive recommended therapies for COPD and COPD exacerbations, up to two-thirds of ...

Patient Experiences of Integrated Care in Medicare Accountable Care Organizations and Medicare Advantage Versus Traditional Fee-for-Service

Health insurance design can influence the extent to which clinical care is well-coordinated. Through alternative payment models, Medicare Advantage (MA) and Accountable Care Organizations (ACOs) have the potential to improve integration relative to traditional fee-for-service (FFS) Medicare.

ARIA 2019: An Integrated Care Pathway for Allergic Rhinitis in Portugal

The Allergic Rhinitis and Its Impact on Asthma (ARIA) initiative started more than 20 years ago and has developed and disseminated evidence-based guidelines and projects in the field of allergic rhinitis. This initiative is currently focused on providing patient-centred guidelines that contribute to an integrated care pathway between the various levels of care and take advantage of digital solutions, and the introduction of integrated care pathways in clinical practice has been recommended. In this article we describe the adaptation for Portugal of the ARIA Integrated Care Pathways document. After a brief review of the epidemiology and impact of allergic rhinitis ...

OPEN ARCH integrated care model: experiences of older Australians and their carers

There is worldwide recognition of the need to redesign health service delivery with a focus on strengthening primary health care and aligning health and social care through integrated models. A defining feature of integrated models is improved patient and carer experience of care. This study explored the experiences of older people and their carers enrolled in a unique model of integrated care that provides a specialist geriatric intervention in the primary care setting for older adults with complex needs in Far North Queensland. A qualitative exploratory descriptive design using semistructured interviews was used to address the study aims. Seventeen older ...

What day is today? Cognitive capacity and the risk of incident dementia in the context of integrated care for older people (ICOPE Step 1)

Based on clinical observations, our objective was to test if the older adults who failed to recall the name of the weekday, or had a higher number of mistakes in the word recall were at higher risk of mild cognitive impairment (MCI) or dementia. Longitudinal data of the Multidomain Alzheimer Preventive Trial (MAPT) was used to retrospectively measure the cognitive capacity according to the ICOPE Step 1 tool. Incident dementia was assessed by two multidisciplinary committees independent from each other. MCI was defined as Clinical Dementia Rating scale CDR = 0.5. Failure to recall the name of the weekday had ...

Effectiveness of a pathway-driven eHealth-based integrated care model (PEICM) for community-based hypertension management in China: study protocol for a randomized controlled trial

The prevalence of hypertension is high and increasing in China in recent years. The treatment and control of hypertension calls for long-term management beyond hospital, which is hard to implement in traditional care settings. Integrated care combined with information technology can promote high-quality healthcare services across the life-course. However, few studies have applied a customized integrated care model in community-based hypertension management in China, catering to the emerging “three-manager” mode. This study aims to identify the effectiveness of a pathway-driven eHealth-based integrated model that implemented as a full-featured telehealth system to facilitate standardized management of hypertension in China.

Learning from the Pandemic to Improve Care for Vulnerable Communities: The Perspectives and Recommendations from the Rare Disease Community

The COVID-19 pandemic has brought about health and social care disruptions for millions of people with complex health needs and disabilities, who are amongst the most vulnerable populations. More than ever before, the need for integrated care is pressing, as fragmented health and care systems struggle to face the pandemic and vulnerable individuals are exposed to aggravated health, social and economic hurdles. The implementation of effective integrated care pathways is long due and must build upon the key guidelines being published by experts worldwide. Furthermore, the pandemic is opening the doors for more remote healthcare and care coordination, with both ...

Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study

The aim of this study was to co-create a definition and generic descriptors for person-centred coordinated care for Ireland generated from service users’ narratives.

An overarching action research approach was used to engage and empower people to tangibly impact health policy and practice. Through focus groups and a qualitative survey, primary data were collected from a national sample of health services users, caregivers and health care service users’ representative groups. Thematic analysis was used to analyse the data. Three major themes were co-produced as essential care elements. These were: ‘My experience of healthcare’, ‘Care that I am confident in’ and ...

How to Ensure Referral and Uptake for COPD Rehabilitation – Part 2: A Case of Integrated Care on How to Translate Findings of Cross- Sectorial Workflow to Improve Cross-Sectorial Rehabilitation

Patients with chronic obstructive pulmonary disease (COPD) can greatly benefit from rehabilitation initiatives, but referral to rehabilitation is sparse. Before we initiated activities to ensure hospital referrals for prevention initiatives at the municipality, we investigated referral patterns and relevant factors in the cross-sectorial workflow.

This study aims to ensure referral to municipality COPD rehabilitation, by simplifying the referral procedures, and by facilitating relational coordination across the two health care settings.

Comparison of Integrated Care of the Elderly in Iran with Other Selected Countries, a Comparative Study

The current situation of the population of Iran is such that at present the population has changed from the explosive situation of the child population to the increase of the elderly population. The aim of this study was to compare the integrated care of the elderly in Iran with other selected countries.