International Journal of Integrated Care最新文献

{"title":"Ngaramadhi Space: An Integrated, Multisector Model of Care for Students Experiencing Problematic Externalising Behaviour.","authors":"Santuri Rungan, Susan Gardner, Huei-Ming Liu, Susan Woolfenden, Jennifer Smith-Merry, John Eastwood","doi":"10.5334/ijic.7612","DOIUrl":"https://doi.org/10.5334/ijic.7612","url":null,"abstract":"<p><strong>Introduction: </strong>Behavioural and emotional disorders are a significant cause of morbidity for young people aged 10-19 years. School-based health care (SBHC) provides an innovative approach to addressing these issues within Australia.</p><p><strong>Description: </strong>We describe an innovative and integrative SBHC model called Ngaramadhi Space (NS) based at a specialised behavioural school called Yudi Gunyi school (YGS) in metropolitan Sydney, Australia. NS was developed in partnership with the Aboriginal community to provide holistic, integrated, multidisciplinary child and family centred care to students experiencing problematic externalising behaviour. We contextualise the historical factors leading to the development of NS, highlighting the importance of effective partnerships between sectors, and providing the theoretical framework and key components underpinning the model of care.</p><p><strong>Discussion: </strong>In Australia, schools are an under-utilised resource for the delivery of health and support alongside education. Collaboration between sectors can be challenging but allows a more coordinated approach to the management of complex social and health issues. By forming effective partnerships with schools and communities, the health sector has an opportunity to improve access to health and social care in a culturally safe and acceptable way. This is in line with national and international frameworks for improving health service delivery and addressing inequity.</p><p><strong>Conclusion: </strong>The health sector can play a pivotal role in improving the wellbeing of children by forming effective partnerships with schools and communities. The NS model is a practice-based example of this.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"23 4","pages":"19"},"PeriodicalIF":2.4,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138799841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Person-Centred Integrated Care to People with Complex Chronic Conditions: Early Implementation Results of the ProPCC Programme.","authors":"Miquel À Mas, Ramón Miralles, Maria J Ulldemolins, Ria Garcia, Sonia Gràcia, Josep M Picaza, Mercedes Navarro Fernández, Maria A Rocabayera, Montserrat Rivera, Núria Relaño, Mireia Torres Asensio, Pilar Laporta, Celia Morcillo, Laura Nadal, Ramona Hervás, Dolors Fuguet, Cristina Alba, Núria Miralles Banqué, Sònia Jimenez, Miriam Moreno Moreno, Carmen Nogueras, Helena Manjón Navarro, Rosa López, Guillem Hernández, Francesc López-Seguí, Laura Ricou Ríos, Arnau Pons, Nuria Prat, Jordi Ara Del Rey, Oriol Estrada","doi":"10.5334/ijic.7585","DOIUrl":"https://doi.org/10.5334/ijic.7585","url":null,"abstract":"<p><strong>Introduction: </strong>The evaluation of integrated care programmes for <i>high-need high-cost</i> older people is a challenge. We aim to share the early implementation results of the ProPCC programme in the North-Barcelona metropolitan area, in Catalonia, Spain.</p><p><strong>Methods: </strong>We analysed the intervention with retrospective data from May 2018 to December 2021 by describing the cohort complexity and by showing its 6-months pre-post impact on time spent at home and resources used: primary care visits, emergency department visits, hospital admissions and hospital stay.</p><p><strong>Findings: </strong>264 cases were included (91% at home; 9% in nursing homes). 6-month pre vs. 6-months post results were (mean, p-value): primary care visits 8.2 vs. 11.5 (p < 0.05); emergency department visits 1.4 vs. 0.9 (p < 0.05); hospital admissions 0.7 vs. 0.5 (p < 0.05); hospital stay 12.8 vs. 7.9 days (p < 0.05). Time spent at home was 169.2 vs.174.2 days (p < 0.05).</p><p><strong>Conclusion: </strong>Early implementation of the ProPCC programme results in an increase in time spent at home (up to 3%) and significant reductions in emergency department attendance (-37.2%) and hospital stays (-38.3%). The increased use of primary care resources is compensated by the hospital resources savings, with a result in the average total cost of -46.3%.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"23 4","pages":"18"},"PeriodicalIF":2.4,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138799502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Care: A Person-Centered and Population Health Strategy for the COVID-19 Pandemic Recovery and Beyond.","authors":"Ayodele Odutayo, Kevin Smith, Carolyn Gosse, Melissa Chang, Shiran Isaacksz, Christopher T Chan","doi":"10.5334/ijic.7536","DOIUrl":"https://doi.org/10.5334/ijic.7536","url":null,"abstract":"<p><p>The COVID-19 pandemic has mandated a re-imagination of how healthcare is administered and delivered, with a view towards focusing on person-centred care and advancing population health while increasing capacity, access and equity in the healthcare system. These goals can be achieved through healthcare integration. In 2019, the University Health Network (UHN), a consortium of four quaternary care hospitals in Ontario, Canada, established the first stage of a pilot program to increase healthcare integration at the institutional level and vertically with other primary, secondary and tertiary institutions in the Ontario healthcare system. Implementation of the program was accelerated during the COVID-19 pandemic and demonstrated how healthcare integration improves person-centred care and population health; therefore serving as the foundation for a health system response for the COVID-19 pandemic recovery and beyond.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"23 4","pages":"16"},"PeriodicalIF":2.4,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138799724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health System Enablers and Barriers to Continuity of Care for First Nations Peoples Living with Chronic Disease.","authors":"Maria Alejandra Pinero de Plaza, Lemlem Gebremichael, Shannon Brown, Chiung-Jung Wu, Robyn A Clark, Katharine McBride, Sonia Hines, Odette Pearson, Kim Morey","doi":"10.5334/ijic.7643","DOIUrl":"10.5334/ijic.7643","url":null,"abstract":"<p><strong>Introduction: </strong>Failings in providing continuity of care following an acute event for a chronic disease contribute to care inequities for First Nations Peoples in Australia, Canada, and Aotearoa (New Zealand).</p><p><strong>Methods: </strong>A rapid narrative review, including primary studies published in English from Medline, Embase, PsycINFO, and Cochrane Central, concerning chronic diseases (cancer, cardiovascular disease, chronic kidney disease, diabetes, and related complications), was conducted. Barriers and enablers to continuity of care for First Nations Peoples were explored considering an empirical lens from the World Health Organization framework on integrated person-centred health services.</p><p><strong>Results: </strong>Barriers included a need for more community initiatives, health and social care networks, and coaching and peer support. Enabling strategies included care adapted to patients' cultural beliefs and behavioural, personal, and family influences; continued and trusting relationships among providers, patients, and caregivers; and provision of flexible, consistent, adaptable care along the continuum.</p><p><strong>Discussion: </strong>The support and co-creation of care solutions must be a dialogical participatory process adapted to each community.</p><p><strong>Conclusions: </strong>Health and social care should be harmonised with First Nations Peoples' cultural beliefs and family influences. Sustainable strategies require a co-design commitment for well-funded flexible care plans considering coaching and peer support across the lifespan.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"23 4","pages":"17"},"PeriodicalIF":2.6,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138799679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Cooperation Work on Management Continuity of Ambulatory Cardiovascular Care: A Cross-Sectional Exploratory Study in Germany","authors":"Christine Arnold, Patrick Hennrich, Frank Peters-Klimm, Michel Wensing","doi":"10.5334/ijic.7019","DOIUrl":"https://doi.org/10.5334/ijic.7019","url":null,"abstract":"Introduction: A wide range of factors influence coordination and continuity of care. The aim of this study was to explore how management continuity of cardiovascular-related ambulatory care is influenced by the following network characteristics: presence of a case coordinator, network reciprocity, network composition and team climate. Methods: This cross-sectional observational study included three written surveys. The primary outcome management continuity of cardiovascular care was measured with the team/cross-boundary scale in the Nijmegen Continuity Questionnaire. The final analysis comprised a multivariate linear multilevel model with the predictors: presence of a case coordinator, network reciprocity, network composition and team climate. Results: Eighteen general practices with 83 health workers and 340 patients participated. The linear multilevel regression analysis showed a positive influence of team climate on cross-boundary continuity of care (b-coefficient 0.44, 95% confidence interval 0.09–0.78, p = 0.02). No statistically significant influence was measured for the other predictors. Discussion: To improve integrated care, therefore, emphasis should also be placed on promoting the team climate within individual practices. Regarding network characteristics, further research is needed, especially in larger practices. Conclusion: This study showed that team climate had an independent, relevant and statistically significant association with cross-boundary continuity of cardiovascular ambulatory care.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"57 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Psychosocial Care into Orthopedic Settings: A Qualitative Study of Provider Perspectives","authors":"Mira Reichman, Ellie A Briskin, Brooke A. Duarte, A. Vranceanu, V. Grunberg","doi":"10.5334/ijic.7579","DOIUrl":"https://doi.org/10.5334/ijic.7579","url":null,"abstract":"Introduction: Approximately 50% of persons with orthopedic injuries experience psychosocial distress (e.g., depression, anxiety), which can predict chronic pain and disability. Offering psychosocial services in orthopedic settings can promote patient recovery. This study explores health care professionals’ perceptions of and recommendations regarding integrated psychosocial care for orthopedic settings. Methods: We conducted 18 semi-structured focus groups with 79 orthopedic health care professionals (e.g., surgeons, residents, nurses) across three Level I Trauma Centers. This secondary data analysis used the evidence-based Rainbow Model of Integrated Care framework to structure hybrid inductive-deductive qualitative data analysis. Results: Orthopedic health care professionals identified potential benefits to psychosocial service integration across all dimensions of integration (i.e., clinical, professional, organizational, system, functional, and normative). These benefits included increased patient satisfaction with care, decreased burden on medical providers to manage patient distress, and decreased healthcare utilization costs. They also identified barriers (e.g., fast-paced clinic flow, mental health stigma) and offered recommendations to address barriers across dimensions of integration. Conclusion: Integrated psychosocial care for orthopedic trauma patients has the potential to improve patient recovery and long-term physical and mental health outcomes. This work identifies strategies to inform the development and implementation of initiatives to integrate psychosocial services within orthopedic settings.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"10 9","pages":""},"PeriodicalIF":2.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participatory Action Research as a Driver for Health Promotion and Prevention: A Co-creation Process Between Professionals and Citizens in a Deprived Neighbourhood in the Hague.","authors":"Wilma van der Vlegel-Brouwer, Madelon Eelderink, Jet Bussemaker","doi":"10.5334/ijic.7560","DOIUrl":"10.5334/ijic.7560","url":null,"abstract":"<p><strong>Introduction: </strong>Ignited by the persistent health inequalities many cities and neighbourhoods, the 'Healthy and Happy The Hague' network in the Netherlands wanted to gain insight in how prevention and health promotion could become successful in one deprived neighbourhood, Moerwijk.</p><p><strong>Methods: </strong>The cycle of Look-Think-Act of Participatory Action Research was used in which both citizens and professionals got involved from the start. Besides interviews, field notes were analysed, visualised and discussed in several rounds of focus groups.</p><p><strong>Results: </strong>Thematic analysis yielded seven themes: Healthy Eating and Exercise, Healthy Money, Healthy Mind, Healthy Relationships, Growing up healthy, Healthy Environment and Healthy Collaboration. During sessions around combination of themes, eight initiatives were co-created by citizens and professionals together, improving the feeling of ownership and interconnectedness.</p><p><strong>Discussion and conclusion: </strong>This PAR sheds a light on the mismatch between the system world's solutions for individuals and the living world's needs for solutions for the collective. Findings provides a better insight into the social, political, and cultural mechanisms and processes that influence clustering and interaction of health conditions. PAR is a promising process of citizens and professionals working together is an excellent way to learn about the conditions under which people experience health inequalities, and how to combat these inequalities.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"23 4","pages":"13"},"PeriodicalIF":2.6,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring the Impact of Integrated Care: from Principles to Real-World Impact.","authors":"Jessica Michgelsen, Nick Zonneveld, Ephrem Tesfay, Mirella Minkman","doi":"10.5334/ijic.7783","DOIUrl":"10.5334/ijic.7783","url":null,"abstract":"","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"23 4","pages":"12"},"PeriodicalIF":2.4,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of the Relationship between Training of Health Practitioners in a Person-Centred Care Model and their Person-Centred Attitudes.","authors":"Esther Li Ping Lim, Rebecca Hui Shan Ong, Johan Thor, Monika Allgurin, Boel Andersson Gäre, Julian Thumboo","doi":"10.5334/ijic.7564","DOIUrl":"https://doi.org/10.5334/ijic.7564","url":null,"abstract":"<p><strong>Introduction: </strong>The Esther Network (EN) person-centred care (PCC) advocacy training aims to promote person-centred attitudes among health practitioners in Singapore. This study aimed to assess the relationship between the training and practitioners' PCC attributes over a 3-month period, and to explore power sharing by examining the PCC dimensions of \"caring about the service user as a whole person\" and the \"sharing of power, control and information\".</p><p><strong>Methods: </strong>A repeated-measure study design utilising the Patient-Practitioner Orientation Scale (PPOS), was administered to 437 training participants at three time points - before training (T1), immediately after (T2) and three months after training (T3). A five-statement questionnaire captured knowledge of person-centred care at T1 and T2. An Overall score, Caring and Sharing sub-scores were derived from the PPOS. Scores were ranked and divided into three groups (high, medium and low). Ordinal Generalised Estimating Equation (GEE) model analysed changes in PPOS scores over time.</p><p><strong>Results: </strong>A single, short-term training appeared to result in measurable improvements in person-centredness of health practitioners, with slight attenuation at T3. There was greater tendency to \"care\" than to \"share power\" with service users across all three time points, but the degree of improvement was larger for sharing after training. The change in overall person-centred scores varied by sex and profession (females score higher than males, allied health showed a smaller attenuation at T3).</p><p><strong>Conclusion: </strong>Training as a specific intervention, appeared to have potential to increase health practitioners' person-centredness but the aspect of equalising power was harder to achieve within a hierarchical structure and clinician-centric culture. An ongoing network to build relationships, and a supportive system to facilitate individual and organisational reflexivity can reinforce learning.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"23 4","pages":"11"},"PeriodicalIF":2.4,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of RuralkidsGPS; A Novel Integrated Paediatric Care Coordination Model of Care in Rural Australia - a Mixed-Methods Study Protocol.","authors":"Raghu Lingam, Hayley Smithers-Sheedy, Stephanie Hodgson, Karen Hutchinson, Tammy Meyers Morris, Nan Hu, Natasha Nassar, Elizabeth-Ann Schroeder, Rezwanul Rana, Emma Dickins, Kirsten Bula, Yvonne Zurynski","doi":"10.5334/ijic.7008","DOIUrl":"https://doi.org/10.5334/ijic.7008","url":null,"abstract":"<p><strong>Introduction: </strong>The Kids Guided Personalised Service (KidsGPS) is an integrated model of care coordination for children and young people (CYP) living with medical complexity. After successful implementation in an urban setting, the model of care will be rolled-out at scale to four rural regions in New South Wales, Australia to establish RuralKidsGPS. This paper describes the approach and methods for the outcome and implementation evaluation of RuralKidsGPS.</p><p><strong>Description: </strong>The evaluation aims to assess health, economic and implementation outcomes and processes whilst identifying barriers and enablers to inform future rollouts. Measures of health service utilisation (primary outcome), child health related quality of life and parent/carer experiences will be assessed. The implementation evaluation will occur alongside the outcomes evaluation and is underpinned by the Consolidated Framework for Implementation Research and informed by validated quantitative measures and qualitative interviews with patients, families, healthcare providers and service managers. An economic analysis will determine incremental cost effectiveness ratios for the new model of care using health service utilisation data.</p><p><strong>Conclusion: </strong>RuralKidsGPS, if effective, has the potential to improve equity of access to integrated care for CYP and their families and this protocol may inform other evaluations of similar models of care delivered at scale.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"23 4","pages":"10"},"PeriodicalIF":2.4,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}