Patient perceptions of innovative longitudinal integrated clerkships based in regional, rural and remote primary care: a qualitative study

Medical students at the University of Wollomgong experience continuity of patien care and clinical supervision during an innovative year-long integrated (community and hospital) clinical clerkship. In this model of clinical education, students are base in a general practice "teaching microsystem" and participate in patient care as part of this community of practice (CoP). This study evaluates patient´s preceptions of the clerkship initiative, and their perspectives in this approach to training´much needed´doctors in their community. 

Health assessments for health governance—concepts and methodologies

For better supporting science-governance interface, the potential of health assessments appear underrated. The aims of this article is to identify what various types of health assessment have in common; how they differ, which assessments to apply for which purpose; and what needs and options there are for future joint development. 

Interventions and approaches to integrating HIV and mental health services: a systematic review

• Available literature on interventions integrating HIV and mental health services reveal that there is much diversity in the approaches adopted in combining treatment modalities; ranging from integration within a single facility, to multi-facility integration, and integrated care coordinated by non-physician case managers.

• Existing evidence, although limited, suggest that integrating HIV and mental health services may be linked to improved patient and service delivery outcomes in diverse settings.

• There is a need for higher quality and robustly designed studies to evaluate and compare integration models at different levels of service delivery in terms ...

The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization

The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization reviews PCMH results from 45 peer-reviewed reports and additional government and state evaluations. Implementation of the PCMH and high performing primary care differs depending upon the needs and preferences of those delivering, receiving, and paying for related care. 

The sixth annual PCPCC report, authored by the Robert Graham Center of the American Academy of Family Physicians and published with support from the Milbank Memorial Fund, employed broader search terms and more rigorous search criteria that evaluated studies, reports, and evaluations published between November 1, 2015 to February 28 ...

A Digital NHS? An introduction to the digital agenda and plans for implementation

The SELFIE framework for integrated care for multi-morbidity: Development and description

The rise of multi-morbidity constitutes a serious challenge in health and social care organisation that requires a shift from disease-towards person-centred integrated care. The aim of the current study was to develop a conceptual framework that can aid the development, implementation, description, and evaluation of integrated care programmes for multi-morbidity. The framework structures relevant concepts in integrated care for multimorbidity and can be applied by different stakeholders to guide development, implementation, description, and evaluation. 

What do we mean when we talk about the Triple Aim? A systematic review of evolving definitions and adaptations of the framework at the health system level

Notwithstanding important contributions of the Triple Aim, uncristal enthusiasm regarding the implications of the framework may be leading to  inconsistent use, particularly when apploed at the health system level, which goes beyond he original positioning of the framework as a strategic organizing principle to guide improvement initiatives at the organizational or local community level. This article identified uses of the Triple Aim that extended beyond its original intention to focus on uses at the whole health system level, to assess convergence and divergence with the original definition. They also attempted to identify consistencies in the way the Triple Aim was ...

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal

Mental illnesess are the largest contributors to the global burden of non-communicable diseases. However, there is extremly limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation

Integration of community home based care programmes within national primary health care revitalisation strategies in Ethiopia, Malawi, South-Africa and Zambia: a comparative assessment

In 2008, the WHO facilitated the primary health care (PHC) revitalisation agenda. The purpose was to strengthen African health systems in order to address communicable and non-communicable diseases. The aim of this study was to assess the position of civil society-led community unity home based care programmes (CHBC), which serve the needs of patients with HIV, within this agenda. It examined how their roles and place in health systems evolved, and the prospects for these programmes in national policies and strategies to revitalise PHC, as new health care demands arise. 

“On the Margins and Not the Mainstream": Case Selection for the Implementation of Community based Primary Health Care in Canada and New Zealand

Healthcare system reforms are pushing beyond primary care to more holistic, integrated models of community based primary health care (CBPHC) to better meet the needs of the population. In order to scale up and spread successful models of care it is important to study what works and why. The first step is to select "appropiate" cases to study. In this commentary, this study reflect the difficulty in identifying "successful" models to study, the value of drawing on clinical and organisational networks and experts, and the association between policy context and ease of case selection. Such insights have important implications for ...