Patient-centred care in Hungary: Contributions to foster a policy agenda

In Hungary, the National Health Insurance Fund provides health care coverage for nearly all residents, but healthcare spending is below the EU’s average (6.4% versus 9.9% of the GDP in 2019, respectively). In 1997, patients’ rights were established by laws of the healthcare system. The patients’ voice, however, has remained weakly embedded in decision-making processes both on the system and individual patient levels. Policy progress achieved in the past years may foster patient-centeredness in health policy decision-making. However, people-reported data are not yet embedded in the Hungarian health information system and national population or household surveys, thus ...

Users’ and Providers’ Perceptions about Integrated Health Care in Southern Denmark

Health care systems are increasingly complex, and evidence shows poor coordination of care within and between providers, as well as at the interface between different levels of care. The purpose of this study is to explore users’ and providers’ (stakeholders’) perspectives of integrated care in Denmark. We conducted qualitative interviews with 19 providers and 18 users that were analysed through inductive content analysis. Providers’ and stakeholders’ perceived deficits in system-level factors, lack of organizational culture, weaknesses in communication, a need for a shift towards considering equity in access to health services and focus on person-centeredness. Fundamental changes suggested by participants ...

The forgotten dimension of integrated care: barriers to implementing integrated clinical care in English NHS hospitals

Multimorbid patients who enter English NHS hospitals are frequently subject to care pathways designed to assess, diagnose and treat single medical conditions. Opportunities are thereby lost to offer patients more holistic, person-centred care. Hospital organisations elsewhere are known to use in-hospital, multi-specialty, integrated clinical care (ICC) to overcome this problem. This perspective piece aims to critically discuss barriers to implementing this form of ICC in the English NHS focusing on six key areas: information technologies, the primary–secondary care interface, internal hospital processes, finance, workload, professional roles and behaviours. Integrated care programmes currently underway are largely focused on macro (system ...

Nurses' experiences of person-centred care planning using video-conferencing

The aim was to illuminate how nurses experience person-centred care planning using video conferencing upon hospital discharge of frail older persons. This study provides valuable insights into challenges associated with care planning via video conferencing. The meeting format, that is video conferencing, is perceived as a barrier that makes the interaction challenging. Shortcomings in video technology make a person-centred approach difficult. The person-centred approach is also difficult for nurses to maintain when the older person or relatives are not involved in the planning.

GPs' interest in integrated care for frail older adults and corresponding consulting and prescribing data: qualitative and quantitative analyses of the PAERPA integrated care project

Integrated care pathways can help to avoid unnecessary admissions to hospital and improve the overall quality of care for frail older patients. Although these integrated care pathways should be coordinated by GPs their level of commitment may vary.

The impact of including a medication review in an integrated care pathway: A pilot study

The objective of the present study was to measure the impact of the intervention of combining a medication review with an integrated care approach on potentially inappropriate medications (PIMs) and hospital readmissions in frail older adults.

Health alliance for prudent prescribing and yield of antibiotics in a patient-centred perspective (HAPPY PATIENT): a before-and-after intervention and implementation study protocol

Excessive and inappropriate use of antibiotics is the most important driver of antimicrobial resistance. The aim of the HAPPY PATIENT project is to evaluate the adaptation of European Union (EU) recommendations on the prudent use of antimicrobials in human health by evaluating the impact of a multifaceted intervention targeting different categories of healthcare professionals (HCPs) on common community-acquired infectious diseases, especially respiratory and urinary tract infections.

Patient and health-care provider experience of a person-centred, multidisciplinary, psychosocial support and harm reduction programme for patients with harmful use of alcohol and drug-resistant tuberculosis in Minsk, Belarus

Tuberculosis (TB) often concentrates in groups of people with complex health and social issues, including alcohol use disorders (AUD). Risk of TB, and poor TB treatment outcomes, are substantially elevated in people who have AUD. Médecins sans Frontières and the Belarus Ministry of Health have worked to improve treatment adherence in patients with multi-drug or rifampicin resistant (MDR/RR)-TB and harmful use of alcohol. In 2016, a person-centred, multidisciplinary, psychosocial support and harm reduction programme delivered by TB doctors, counsellors, psychiatrists, health-educators, and social workers was initiated. In 2020, we described patient and provider experiences within the ...

Commissioning [Integrated] Care in England: An Analysis of the Current Decision Context

The emergence of Integrated Care Systems (ICSs) across England poses an additional challenge and responsibility for local commissioners to accelerate the implementation of integrated care programmes and improve the overall efficiency across the system. To do this, ICS healthcare commissioners could learn from the experience of the former local commissioning structures and identify areas of improvement in the commissioning process. This study describes the investment decision process in integrated care amid the transition toward ICSs, highlights challenges, and provides recommendations to inform ICSs in their healthcare commissioning role.

Beyond the Point of No Return: A Discourse Analysis of Healthcare Professionals’ Perceptions of Digitally Supported Person-Centred, Integrated, and Proactive Care

Most countries are facing a common challenge: a rise in the number of chronically ill patients and limited medical resources. The combination of digital support and the principles of person-centred, integrated, and proactive care (Digi-PIP care) services constitutes the most ambitious initiative for patients with long-term needs. While there is research on digital support, person-centred, integrated, and proactive care, the combination of these components has been less explored.

The data set consisted of 29 qualitative interviews with healthcare professionals involved in four Nordic Digi-PIP care initiatives. Building on prevailing discourses on the modernisation of healthcare, we used discourse analysis to ...