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Consumer-directed services: lessons and implications for integrated systems of care
- Author:
- KODNER Dennis L.
- Journal article citation:
- International Journal of Integrated Care, 3(2), 2003, Online only
- Publisher:
- International Foundation for Integrated Care
Over the past decade, policy makers in developed countries have begun to pay increasing attention to reform of the long-term care system for the frail elderly and younger people with disabilities. A continuum of strategies have generated interest, including integrated systems of care with agency/professionally managed service packages on the one end, and programs offering cash benefits along with the flexibility to decide how to best use these funds to meet individual needs and preferences, on the other. The latter approach, known as “consumer-directed care,” is found in various forms and degrees in Europe and North America. Primarily organised around the provision of home and community care, consumer-directed services are aimed at empowering clients and family carers, giving them major control over the what, who and when of needed care. Consumer-directed care appears to be the antithesis of integrated care. However, it actually holds important lessons and implications for the latter. This policy paper explores the rationale and models of consumer-directed services at home, reviews developments, designs and outcomes of programs in the Austria, Germany, the Netherlands, and the US. It also discusses how this experience could be helpful in shaping better and more responsive integrated models of care for vulnerable long term care populations.
Common experiences of staff working in integrated health and social care organisations: a European perspective
- Author:
- COXON Kirsite
- Journal article citation:
- Journal of Integrated Care, 13(2), April 2005, pp.13-21.
- Publisher:
- Emerald
Presents a comparison of the views of staff working in 18 integrated care settings, undertaken as part of the PROCARE study of integrated health and social care. The data reveals commonalities across the nine European countries (Austria, France, Germany, Italy, Finland, UK, Denmark, Greece and the Netherlands). Increased job satisfaction was an advantage of integrated working, but respondents also reported difficulties in working with hospitals or medical professionals, and continued barriers to integrated working generally. Single standalone organisations such as home care teams reported the clearest benefits from integrated working, while cross-agency models continued to encounter significant barriers to health and social care integration.