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Integrating health and social care from an international perspective
- Authors:
- WATSON Jessica, INTERNATIONAL LONGEVITY CENTRE UK
- Publisher:
- International Longevity Centre Global Alliance
- Publication year:
- 2012
- Pagination:
- 10
- Place of publication:
- London
This report draws on the ideas, issues and challenges of integrating care raised at the Conference on Integrated Care for Frail Older People held on 29th September 2011. The conference was organised by ILC-Netherlands in cooperation with the Leyden Academy, the Dutch Medical Research Council, Vilans (a Centre of Expertise for Long-term Care) and the International Longevity Centre Global Alliance. This report links to previous research conducted by ILC-UK on integrating health and social care (Lloyd and Wait, 2006). It examines the potential benefit of integrating health and social care services for frail older people in a global context. It highlights that while financial, cultural and logistical barriers exist, countries should continue to work towards integrating health and social care services given its possibilities for cost efficiency, freeing up acute healthcare facilities and benefits for service users. It covers: the need for integrated care; the current global context of care for frail older people; the benefits and challenges of integrating health and social care services for this group; and priorities for action in advancing the issue of integrated care worldwide (Edited publisher abstract)
Caring for an ageing population: points to consider from reform in Japan
- Authors:
- CURRY Natasha, PATTERSON Linda, HOLDER Holly
- Publisher:
- Nuffield Foundation
- Publication year:
- 2013
- Pagination:
- 42
- Place of publication:
- London
Japan has the world’s oldest population, 23% being aged 65+. In order to relieve the pressure on its health and social care system, the country introduced Long Term Care Insurance (LTCI) in 2000, a compulsory scheme for those aged over 40, which offers access to social care for those aged over 65 on the basis of need alone. At the heart of the LTCI system is the care manager who is responsible for developing a package of care and advising individuals of their options. While quality of provision was not initially built into the system, it became a central focus in 2005. The authors describe two models of provision: integrated delivery systems; and dementia group homes. In many ways, the LTCI scheme has been a success, but it has not achieved all that was intended. It has also not been without controversy; and its greatest test is yet to come as it grapples with an older population that already accounts for nearly one quarter of its population. It will be useful for England to reflect on the Japanese experience, for its challenges and difficulties are as valuable as its successes in helping shed light on options for social care in England. This report is from a project part funded by the Great Britain Sasakawa Foundation, ‘Universal access and low costs? Health and social care the Japanese way’, which included a study visit to Japan in 2012, during which a variety of organisations, policy-makers, clinicians and academics were visited. (Edited publisher abstract)
Integrated care for older people in Europe: latest trends and perceptions
- Author:
- LEICHSENRING Kai
- Journal article citation:
- International Journal of Integrated Care, 12(1), 2012, Online only
- Publisher:
- International Foundation for Integrated Care
This perspectives paper reflects upon the authors experience in researching long-term care, the rationale for creating integrated long-term care systems, and discusses some innovations. As a researcher and consultant he has coordinated local pilots and European research projects to improve long-term care for older people by better integrating health and social care systems. One of his main conclusions is the need to treat long-term care as a system in its own right. It is suggested that long-term care systems require a discernable identity; specific policies, structures, processes and pathways; and the leadership and resources that can underpin expectations, drive performance for better outcomes for those living with (and working for those with) long-term care needs. The author notes that progress in developing LTC systems can be identified in all European countries. Integrated care solutions at the interface of health and social care, and between formal and informal care, have appeared. He notes that these have been achieved partly by means of (slow) political reforms, partly as a response to market-oriented governance, and in many cases through pioneering community and civil society initiatives. The paper concludes that it will depend on such initiatives, and their ability to convince both citizens and policy-makers, as to whether new societal approaches to long-term care are created that meet the demands of ageing societies.
PACE: a model for providing comprehensive healthcare for frail elders
- Author:
- TRICE Laura
- Journal article citation:
- Generations, 30(3), 2006, pp.90-92.
- Publisher:
- American Society on Aging
The Program of All-Inclusive Care for the Elderly (PACE) is an innovative long-term-care model in the United States that allows frail elders to remain at home. PACE enables frail older people who are eligible for nursing home care to continue living in the community with the full spectrum of medial, social and rehabilitative services. This article provides an overview of the PACE model highlighting its practice innovations, its key outcomes, and barriers to growth.
An uncertain age: reimagining long term care in the 21st century
- Author:
- KPMG INTERNATIONAL
- Publisher:
- KPMG International
- Publication year:
- 2013
- Pagination:
- 56
- Place of publication:
- London
The Lien Foundation, a philanothropic organisation in Singapore, commissioned KPMG International to produce this report, to inform and stimulate global debate on the long term care of older people. Experts from the aged care sector worldwide were interviewed for their views. While no single breakthrough idea emerged, there were some highly innovative and interesting approaches, and three findings stand out as being critical and relevant: Firstly, the debate on funding and finance threatens to obscure the scale and gravity of the overall challenge. Secondly, care should be redesigned to break down organisational boundaries through greater integration: the medical model must change to accommodate practical methods that pay more attention to people’s needs, rather than to the treatment of disease. Lastly, discussion of this subject must involve government, private and non-governmental bodies and providers, as well as the wider public. Person-centred care; investing in human and technological resources; change attitudes and policies towards ageing. The report is arranged in two main sections, the first on the current state of long term care. It quantifies "the narrowing longevity gap", pressure on traditional family-based care. resource challenges and workforce shortages Section 2, on shaping tomorrow’s long term care systems, considers: delivery of person-centred care; integrating care; rethinking medical care; looking beyond institutional boundaries toward the community; investing in the formal and informal workforce; using technology; focusing on outcomes; developing better funding models; and changing attitudes to ageing. The conclusion notes that governments need to emulate countries such as Australia, where a 10-year plan for a seamless system of care is being implemented. (Edited publisher abstract)
Reimagining nursing homes: the art of the possible
- Author:
- KANE Robert L.
- Journal article citation:
- Journal of Aging and Social Policy, 22(4), October 2010, pp.321-333.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
The author believes that good long term care (LTC) needs to be reconceptualised. It requires the integration of personal care, housing and medical care but succeeding on all three levels simultaneously is rare, especially in nursing homes which have become the symbol of LTC. It is suggested that current efforts to reinvent the nursing home perpetuate a flawed model of care and that the heritage of the nursing home as the dominant model for LTC needs to be reexamined. The article goes on to discuss the basic LTC building blocks of, housing, services, and medical care, and ways in which they can be combined to meet consumers' needs and preferences for assisted living in individualised scenarios. It is suggested that what is needed are innovative solutions that can offer reasonable service while recognising the value of acceptable risk taking; modest personal care should not come at the price of surrendering one's autonomy. The author believes that LTC should be higher on the public policy agenda and more people need to ask why they are paying a lot for care they do not want.
Reforming long-term care in Portugal: dealing with the multidimensional character of quality
- Author:
- SANTANA Silvina
- Journal article citation:
- Social Policy and Administration, 44(4), August 2010, pp.512-528.
- Publisher:
- Wiley
This article provides an overview of the informal and institutional setting of long-term care in Portugal and focuses on service quality, discussing it alongside broader problems related to the organisation of long-term care in the country. It analyses the main providers, discussing structural, organisational, quality and financing aspects of a very complex situation that is currently evolving at a very fast pace, in adapting to Portuguese society’s new needs in the social care network and the recent introduction of what is designated as a third level of care, the National Network of Long-term Integrated Care (Rede Nacional de Cuidados Continuados Integrados – RNCCI). It presents the results of the first self-assessments these bodies have made of the quality and suitability of services provided from the users’ point of view. The results of a survey conducted by the Eurobarometer between 25 May and 30 June 2007 on the attitudes, needs and expectations of Portuguese citizens regarding long-term care and care of the elderly are discussed. The article concludes that the information and data available are insufficient to support any deep analysis of the situation and field action, and sets some lines for future work in this area.
Reflections on integrating medical and social care: five laws revisited
- Author:
- LEUTZ Walter
- Journal article citation:
- Journal of Integrated Care, 13(5), October 2005, pp.3-12.
- Publisher:
- Emerald
This paper reviews, rethinks, expands and applies the author's 'laws' of integration, which were first published six years ago. This approach both introduces the laws to readers who don't know them, and tests their utility for those who do. The author looks at the 'laws' in relation to the questions: Why is integration so difficult? Can it be made any easier? and What other guides for integration exist.
Fully integrated care for frail elderly: two American models
- Authors:
- KODNER Dennis L., KYRIACOU Corinne Kay
- Journal article citation:
- International Journal of Integrated Care, 1, 2000, Online only
- Publisher:
- International Foundation for Integrated Care
Integrated care for the frail elderly and other populations with complex, chronic, disabling conditions has taken centre stage among policymakers, planners and providers in the United States and other countries. There is a growing belief that integrated care strategies offer the potential to improve service co-ordination, quality outcomes, and efficiency. This article examines so-called “fully integrated” models of care in detail, concentrating on two major, well-established American programs, the social health maintenance organisation and the program of all-inclusive care for the elderly. The article builds upon the work of Walter Leutz, to develop a framework by which these programs can be analysed. This analysis strongly suggests that fully integrated models of care, such as the social health maintenance organisation and program of all-inclusive care for the elderly, are not only feasible, but offer significant potential to improve the delivery of health and social care for frail elderly patients. In addition, the authors identify the factors that are the most critical to the success of fully integrated care, and offer lessons for their development and implementation. Finally, issues are raised concerning the transferability of this complex model to other countries, as well as the vital importance of evidence-based evaluation research in furthering the evolution of integrated care.
ICT-enabled social innovation to support the implementation of the social investment package: mapping and analysis of ICT-enabled social innovation initiatives promoting social investment in integrated approaches to the provision of social services...
- Authors:
- MISURACA Gianluca, et al
- Publisher:
- European Commission. Joint Research Centre
- Publication year:
- 2016
- Pagination:
- 172
- Place of publication:
- Brussels
This report presents an analysis of the 2015 mapping of the EU project 'ICT-enabled Social Innovation to support the implementation of the Social Investment Package' (IESI). It provides a picture of existing evidence of how ICT-enabled social innovation initiatives that promote social investment through integrated approaches to social services delivery can contribute to the policy objectives of the EU Social Investment Package (SIP). The report provides an overview of the methodology followed for building the IESI inventory of ICT-enabled social innovation initiatives through a structured dynamic database and by conducting the mapping and analysis of a selected sample of 210 initiatives. The analysis presents the IESI Knowledge Map 2015, which aims to provide a better understanding of the main characteristics and patterns of the initiatives. Reference is also made to the different welfare systems and social services delivery models which characterise various EU countries in order to contextualise the potential role played by ICT-enabled social innovation to promote social investment. An analysis of the findings are discussed in relation to the role of social enterprise-driven ICT-enabled social innovation initiatives that support: social services delivery; the active inclusion of young people; and prevention, health promotion and rehabilitation in active and healthy ageing and long term care for older people. Finally, conclusions deriving from the analysis of the mapping of the contribution made by ICT-enabled social innovation initiatives are outlined. This is complemented by an analysis of the gaps identified; the limitations of the current mapping exercise and recommendations for future research, as well as implications and possible directions for policy. (Edited publisher abstract)