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WHO regional consultation on strengthening integrated long-term care provision
- Author:
- WORLD HEALTH ORGANIZATION. Regional Office for Europe
- Publisher:
- World Health Organization. Regional Office for Europe
- Publication year:
- 2021
- Pagination:
- 25
- Place of publication:
- Copenhagen
A high degree of variability characterizes the organization, delivery and financing of long-term care in the WHO European Region. Despite this diversity, a common set of challenges, rendered more acute by the devastating effects of the COVID-19 pandemic, increasingly are emerging as key priorities for health and social policy agendas. In response to requests from Member States and in line with the recommendations of the Pan-European Commission on Health and Sustainable Development, the WHO Regional Office for Europe is committed to supporting countries in the Region to turn these common challenges into opportunities for accelerating progress on integrated provision of care services. To ensure Member States are supported adequately in their efforts to strengthen and develop integrated long-term care provision, the WHO Regional Office for Europe convened a regional consultation on strengthening integrated long-term care provision to present WHO tools and resources to Member States, identify priority areas for action at national level and establish where technical support can be provided. This report sets out a summary of presentations at the regional consultation. (Edited publisher abstract)
Barriers and facilitators in the uptake of integrated care pathways for older patients by healthcare professionals: a qualitative analysis of the French national “Health Pathway of Seniors for Preserved Autonomy” pilot program
- Authors:
- LORETTE Lorette, et al
- Journal article citation:
- International Journal of Integrated Care, 21(2), 2021, p.7. Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: Integrated care is a particularly promising approach in geriatrics – a field in which the medical, psychological and social issues are often complex. The uptake of integrated care by healthcare professionals (HCPs) is essential but varies markedly. The objective of the present study of healthcare professionals was to identify barriers to and facilitators of commitment to integrated care for seniors. Methods: We performed a two-step, qualitative study, comprising (i) six qualitative, semi-directive series of interviews with HCPs (hospital practitioners, family physicians, nurses and pharmacists) who agreed or disagreed to take part in the French national “Health Pathway of Seniors for Preserved Autonomy” (PAERPA) pilot program; and (ii) an analysis of the pooled results, in order to identify common concerns among the healthcare professionals. Results: We identified four key “barrier” and “facilitator” topics shared by HCPs who had committed to the pilot program and those who had not: (i) awareness of and/or interest in geriatric medicine and team working, (ii) the presence of a care coordinator; (iii) the provision of information about the program and about the patient, and communication between HCPs, and (iv) personal benefits for the HCPs and the patients. Key conclusions: The four key topics identified in this large qualitative study of several healthcare professions should be considered during the design and dissemination of integrated care pathways for older patients. (Edited publisher abstract)
A rapid response and treatment service for care homes: a case study
- Author:
- WALDON Mandy
- Journal article citation:
- British Journal of Community Nursing, 26(1), 2021,
- Publisher:
- MA Healthcare
- Place of publication:
- London
Rapid response services provide opportunities for older people living with frailty to remain in their own homes during an episode of deteriorating health. The government has announced additional funding to increase capacity and responsiveness for these services through the Ageing Well programme as part of the NHS Long Term Plan. Older people living with frailty are particularly at risk of the adverse effects of a hospital admission and evidence is emerging of the benefits of enhanced healthcare support to allow them to remain in their own home. The Hospital at Home model offers short-term, targeted interventions at acute hospital level care that can provide a truly person-centred experience within the home. This article describes a Rapid Response and Treatment service for older people living in care homes in Berkshire West and shares Sid's story to demonstrate how such a service is delivered. The COVID-19 pandemic has presented additional challenges and opportunities that highlight the ongoing need for the development of services that will support older people to prioritise what matters to them most. (Edited publisher abstract)
Conceptual framework: factors enabling collaborative healthcare and social services integration
- Authors:
- CHENG Siu Mee, CATALLO Cristina
- Journal article citation:
- Journal of Integrated Care, 28(3), 2020, pp.215-229.
- Publisher:
- Emerald
Purpose: A conceptual framework for collaboratively based integrated health and social care (IHSC) integration is proposed to aid in understanding how to accomplish IHSC. Design/methodology/approach: This model is based on extant literature of successfully IHSC initiatives. Findings: The model aims to identify enabling integration factors that support collaborative integration efforts between healthcare and social services organizations. These factors include shared goals and vision, culture, leadership, team-based care, information sharing and communications, performance measurement and accountability agreements, and dedicated resources and financing. It also identifies factors that act as external influencers that can support or hinder integration efforts among collaborating organizations. These factors are geographic setting, funding models, governance structures, and public policies. These factors are intended to ensure that a realist lens is applied when trying to understand and explain IHSC. Originality/value: This model is intended to provide a framework to support research, policy and implementation efforts. (Edited publisher abstract)
Preconditions to implementation of an integrated care process programme
- Authors:
- BANGSBO Angela, et al
- Journal article citation:
- Journal of Integrated Care, 30(1), 2022, pp.66-76.
- Publisher:
- Emerald
Purpose: The purpose of this study was to investigate the preconditions of a full-scale implementation of an integrated care process programme for frail older people from the staff's understanding, commitment and ability to change their work procedures with comparisons over time and between organisations. Design/methodology/approach: A repeated cross-sectional study was conducted in a hospital, municipal health and social care setting. Findings: Staff commitment decreased to the importance of a permanent municipal contact from baseline compared to the 12-months follow-up (p = 0.02) and the six- and 12-months follow-up (p = 0.05), to the information transfer from emergency department from the six- to the 12-months follow-up (p = 0.04), to discharge planning at the hospital at six- and 12-months follow-up (p = 0.04) and towards discharge planning at home from baseline to the six-month follow-up (p = 0.04). Significant differences occurred between the organisations about information transfer from the emergency department (p = 0.01) and discharge planning at home (p = 0.03). The hospital staff were the most committed. Practical implications: The results can guide the implementation of complex interventions in organisations with high-employee turnover and heavy workload. Originality/value: The study design, allowing the comparison of implementation results over time and between organisations in a later phase, gives this study a unique perspective. (Edited publisher abstract)
Comparing nations on timeliness and coordination of health care: findings from the 2021 Commonwealth Fund health policy survey of older adults
- Authors:
- DOTY Michelle M., et al
- Publisher:
- Commonwealth Fund
- Publication year:
- 2021
- Pagination:
- 18
- Place of publication:
- New York
Aging populations present major challenges to health care systems around the world. The 2021 Commonwealth Fund International Health Policy Survey, conducted among adults age 65 and older between March and June 2021, provides insights about how well U.S. seniors fare relative to older adults in 10 other high-income countries. The findings present a mixed picture of U.S. health system performance as the COVID-19 pandemic continues: U.S. seniors are more likely than their counterparts in other wealthy countries to experience economic hardship as a result of the pandemic, with Latino/Hispanic and Black seniors most affected; despite the near-universal coverage Medicare provides, U.S. older adults have comparatively high out-of-pocket health expenses and are much more likely to forgo care because of cost than are their counterparts in the other survey countries. The report also shows that older adults in Germany, the Netherlands, and Switzerland were least likely to have long waits for a doctor’s appointment; older adults in the U.S. were the least likely to experience gaps in hospital discharge planning in the past two years; older adults with chronic conditions in Germany were the most likely to have conversations around care management with their physicians. (Edited publisher abstract)
Service delivery reforms for Asian ageing societies: a cross-country study between Japan, South Korea, China, Thailand, Indonesia, and the Philippines
- Authors:
- NODA Shinichiro, et al
- Journal article citation:
- International Journal of Integrated Care, 21(2), 2021, p.1. Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: Japan’s health policies to address the most advanced-aged society have been the target of focus in Asia, but no studies have investigated this issue using tools for cross-country comparisons. Theory and methods: A cross-country study design was used to compare healthcare reform policies with a framework in Japan, Korea, Thailand, China, Indonesia, and the Philippines. Data were collected via document reviews and key informant interviews. Results: Three distinctions were identified. First, all countries except for the Philippines have policy decisions regarding reforms for the existing service delivery systems for healthcare, long-term care and welfare. Second, the most extensive service delivery reform is currently being implemented in Japan, whose system is shifting to primary health care. Third, the direction of the transformation of service delivery system is different between Thailand and China despite a similar level of ageing society. China has made progress on facility-based care integration between health and social care, whereas Thailand is focusing on home-based care. Conclusions and discussion: Doctor and hospital-based healthcare delivery system requires more drastic reform for an aged society. This fact implies that strengthening primary health care is not only useful for current health issues but also an investment for the aged society near future in low- and middle-income countries. (Edited publisher abstract)
Local system reviews: interim report
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2017
- Pagination:
- 26
- Place of publication:
- Newcastle upon Tyne
Interim report summarising key findings from six local system reviews, carried out to examine how health and adult social care work together. The report looks at the planning, commissioning and delivery of health and social care services across the areas of: system leadership; maintaining the wellbeing of a person in their usual place of residence; care and support when people experience a crisis; and step down services, return to usual place of residence and/or admission to new place of residence. Based on the first six reviews, the findings show a strong commitment from organisations and staff working across health and social care services to provide seamless services for older people needing care and support. However there are still too many examples where care is fragmented and people are often uncertain about who is coordinating their care. The report identifies three themes that could act as a barrier to integration: how providers and commissioners work together; capacity, market supply and workforce issues; and, the need to look beyond delayed transfers of care in isolation to resolve the problems that local systems are facing. It also highlights areas for priority action and emerging themes that should be address at a national level. (Edited publisher abstract)
Stoke-on-Trent: local system review report
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2017
- Pagination:
- 42
- Place of publication:
- Newcastle upon Tyne
One of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that older people living in Stoke-on-Trent sometimes have poor experiences of care and do not always have access to the right care, in the right place at the right time because the health and social care system, led by Stoke-on-Trent City Council and Stoke-on-Trent Clinical Commissioning Group, is not working in a joined up way that is meeting their needs. The reviewers found that organisations and individuals designing and delivering services in Stoke-on-Trent were not working to an agreed, shared vision and that there was a lack of whole system strategic planning and commissioning with little collaboration. This resulted in people finding it difficult to access GP appointments, older people being delayed in hospital, and needs and care packages in the community not being reviewed as regularly as they should be. The review also identifies areas for improvement. (Edited publisher abstract)
Halton: local system review report
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2017
- Pagination:
- 35
- Place of publication:
- Newcastle upon Tyne
One of 20 targeted reviews of local authority areas looking specifically at how older people move through the health and social care system, with a focus on how services work together. The review looks at how hospitals, community health services, GP practices, care homes and homecare agencies work together and whether services are safe, effective, caring, responsive and well led. The review found that there was a strong commitment and a shared vision across the local authority and the clinical commissioning group (CCG) to serve the people of Halton well. There was a positive approach in Halton to maintain people’s health and wellbeing in their own homes, with services designed for older people to keep them socially included, active and able to manage their long term conditions. There was good support for carers including those supporting people living with dementia. Halton had also recently introduced new services introduced to avoid hospital admissions, including a rapid seven-day re-ablement service and a rapid clinical assessment team. Transformation projects for care homes and domiciliary care were underway so that people’s individual needs could be met in a timely way. This had led to a reduction in the numbers of delayed transfers of care and improvements in performance. The review also identifies areas for improvement (Edited publisher abstract)