The integration of health and social care services

The Government is committed to the introduction of a single-tier health service, supported by universal health insurance (UHI). Under UHI, everyone will be insured for a standard package of primary and hospital care services, including mental health services. It is understood that primary and hospital care will be funded mainly via the UHI system and social care services and public health services will be funded by general taxation. While funded separately, these services will need to be delivered in an integrated manner around the needs of the person. This review considers the international evidence in relation to mechanisms and structures ...

Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability.

Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts. 

Methods: The Context and Capabilities for Integrating Care (CCIC) Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks ...

Healthy China : deepening health reform in China building high-quality and value-based service delivery

As many other countries, China faces big challenges to meet the health care needs of her citizens, associated with a rapidly aging society and increasing burden of non-communicable diseases (NCDs). Also, health costs have been growing at a rate higher than GDP growth since 2008.

Since the launch of health reform in 2009, China has invested significantly in health infrastructure at the grassroots level and made progress in building the primary care doctors system. Basic public health services capacity has been significantly enhanced. China is progressing quickly to achieving universal health coverage and some of the reform achievements have attracted ...

Power and Integrated Health Care: Shifting from Governance to Governmentality

Integrated care occurs within micro, meso and macro levels of governance structures, which are shaped by complex power dynamics. Yet theoretically-led notions of power, and scrutiny of its meanings and its functioning, are neglected in the literature on integrated care. We explore an alternative approach. Following a discussion on governance, two streams of theorising power are presented: mainstream and second-stream. Mainstream concepts are based on the notion of power-as-capacity, of one agent ­having the capacity to influence another—so the overall idea is ‘power over ’. Studies on integrated care ­typically employ mainstream ideas, which yield rather limited analyses. Second-stream concepts ...

Elaboration of the Gothenburg model of person-centred care

OBJECTIVE:

In this paper, it is aimed to explore professionals understanding of PCC routines as they implement the GPCC model in a range of different settings.

METHODS:

It is conducted a qualitative study and interviewed 18 clinician-researchers from five health-care professions who were working in seven diverse GPCC projects.

RESULTS:

Interviewees accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships.

CONCLUSION:

This study illustrates what is needed for health-care professionals to implement PCC ...

Meeting the Needs of the Growing Very Old Population: Policy Implications for a Global Challenge

Very old adults are one of the fastest-growing age groups worldwide. Yet they rarely constitute a targeted group for public policies. Drawing on the results of the centenarian studies presented in this special issue, we highlight major challenges that arise from the increase of this population. We outline several promising approaches for policy makers and professionals to develop evidence-based policies and programs that are tailored to the needs of very old adults and their families. We focus our discussion on three key topics essential to life care: the importance of integrated care to meet the complex care needs of the ...

Understanding integrated care: a complex process, a fundamental principle

Recent Editorial in the International Journal on Integrated Care, written by Nick Goodwin, emphasising the importance of the Framework. Around the past year Nick Goodwin has been involved in a range of research and development activities that seek to understand and/or promote the successful adoption of integrated care. In each of these, a common opening statement from protagonists is to typically say that “there is no universally accepted definition of integrated care, no one model of care that can be replicated locally, and little evidence to tell us that it works”. Whilst the latter might be disputed it remains ...

Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil

Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel' perspective in healthcare networks of two countries with different health systems: Colombia, with a social security system based on managed competition and Brazil, with a decentralized national health system. A qualitative, exploratory and descriptive-interpretative study was conducted, based on a case study of ...

No universal health coverage without primary health care

Correspondance

Universal health coverage is currently the aspiration of many countries worldwide. We commend Michael Reich and colleagues for analysing lessons learned from different country experiences, but we believe there is a crucial element neglected within the ongoing universal health coverage debate.

Health-care system development requires more than financing and human resource considerations. Although essential, these components must be integrated into an overall framework for organising and delivering care that best meets population needs. Primary health care provides such a framework, builds the backbone of an effective health-care system, and can improve health, reduce growth in costs, and lower inequality ...

Consolidating the social health insurance schemes in China: towards an equitable and efficient health system

Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health ...