International Journal of Integrated Care最新文献

{"title":"Governing Integrated Health and Social Care: An Analysis of Experiences in Three European Countries.","authors":"Josephine Exley, Rebecca Glover, Martha Mccarey, Sarah Reed, Anam Ahmed, Hubertus Vrijhoef, Tommaso Manacorda, Concetta Vaccaro, Francesco Longo, Ellen Stewart, Nicholas Mays, Ellen Nolte","doi":"10.5334/ijic.7610","DOIUrl":"https://doi.org/10.5334/ijic.7610","url":null,"abstract":"<p><strong>Purpose: </strong>Achieving greater health and social care integration is a policy priority in many countries, but challenges remain. We focused on governance and accountability for integrated care and explored arrangements that shape more integrated delivery models or systems in Italy, the Netherlands and Scotland. We also examined how the COVID-19 pandemic affected existing governance arrangements.</p><p><strong>Design/methodology/approach: </strong>A case study approach involving document review and semi-structured interviews with 35 stakeholders in 10 study sites between February 2021 and April 2022. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to guide our analytical enquiry.</p><p><strong>Findings: </strong>Study sites ranged from bottom-up voluntary agreements in the Netherlands to top-down mandated integration in Scotland. Interviews identified seven themes that were seen to have helped or hindered integration efforts locally. Participants described a disconnect between what national or regional governments aspire to achieve and their own efforts to implement this vision. This resulted in blurred, and sometimes contradictory, lines of accountability between the centre and local sites. Flexibility and time to allow for national policies to be adapted to local contexts, and engaged local leaders, were seen to be key to delivering the integration agenda. Health care, and in particular acute hospital care, was reported to dominate social care in terms of policies, resource allocation and national monitoring systems, thereby undermining better collaboration locally. The pandemic highlighted and exacerbated existing strengths and weaknesses but was not seen as a major disruptor to the overall vision for the health and social care system.</p><p><strong>Research limitations: </strong>We included a relatively small number of interviews per study site, limiting our ability to explore complexities within sites.</p><p><strong>Originality: </strong>This study highlights that governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"9"},"PeriodicalIF":2.4,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722462","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":"Link Workers in Social Prescribing for Young People Work: A Case Study From Sheffield Futures.","authors":"Isabel Farina, Marcello Bertotti, Cristina Masella, Daniela Sangiorgi","doi":"10.5334/ijic.7551","DOIUrl":"https://doi.org/10.5334/ijic.7551","url":null,"abstract":"<p><strong>Introduction: </strong>Social Prescribing has an established recognition regarding the benefits provided to the health-related social needs of adults, but little is known about how the intervention addresses young people's needs. There is optimism regarding the central role of two core mechanisms that allows social prescribing to be effective, such as the empathetic role of Link Workers and the connection with community resources.This paper aims to describe the role played by Link Workers working a Social Prescribing intervention targeting young people.</p><p><strong>Description: </strong>This paper adopts a case study methodology to describe the role of Link Workers addressing young people's needs and implementing Social Prescribing scheme in Sheffield (UK). Data were collected through semi-structured interviews with four of the seven link workers of one organisation based in Sheffield. Data were analysed through an inductive approach for emerging themes.</p><p><strong>Discussion: </strong>We provided a description of the profiles and background of Link Workers and described the three models of referral pathways into the intervention. The paper also shows how Link Workers identify young people's needs and how they connect with the community.</p><p><strong>Conclusion: </strong>Based on the insights and the internationally accepted definition of Social Prescribing, we provide a visual representation of the Social Prescribing model and discuss challenges. The paper highlights lessons learned and future directions regarding the role of Link Workers from the case study.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"8"},"PeriodicalIF":2.4,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10854417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722463","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 Continuity of Care: What Can Physician Survey Add?","authors":"Igor Sheiman, Sergey Shishkin","doi":"10.5334/ijic.7018","DOIUrl":"10.5334/ijic.7018","url":null,"abstract":"<p><strong>Background: </strong>The evaluation of continuity of care is usually based on the indicators of the frequency of patients' contacts with specific providers. There are some first attempts to use physician survey for the evaluation.</p><p><strong>Objective: </strong>Is to get additional information on the continuity of care in Russia by a newly developed physician questionnaire with detailed questions related to the specific areas of providers' interaction in the health system.</p><p><strong>Methods: </strong>The questionnaire was developed to increase the number of characteristics and indicators for the evaluation of informational, longitudinal and interpersonal continuity. Each of 17 questions was pretested by a group of experts. A small physician survey was conducted through the mobile App with 2690 respondents. A sample is skewed to young and urban respondents. The attempts have been made to increase its representativeness.</p><p><strong>Results and discussion: </strong>We identified the areas of low continuity of care in Russia. Access to electronic medical records is limited. Outpatient and inpatient physicians rarely contact with each other. Primary care physicians are unaware of the substantial part of hospital admissions and emergency visits of their patients, which makes them unprepared for the follow-up treatment. Home visits to patients with heart attack and stroke after hospital discharge are rare. The lack of timely transfer of hospital cases to rehabilitative and social care settings also limits continuity of care. However, a small scale of the survey and its online operation limit its representativeness and robustness. Bigger scale of the survey with the same or similar questionnaire can improve its results.</p><p><strong>Conclusion: </strong>Physician survey can be a useful instrument of care continuity evaluation. The content of the suggested survey can be valuable for collecting the international evidence.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"5"},"PeriodicalIF":2.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681082","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":"Supporting Quality Integrated Care for Adolescent Depression in Primary Care: A Learning System Approach.","authors":"Diana Sarakbi, Dianne Groll, Joan Tranmer, Rodger Kessler, Kim Sears","doi":"10.5334/ijic.7685","DOIUrl":"10.5334/ijic.7685","url":null,"abstract":"<p><strong>Background: </strong>Quality integrated care, which involves primary care and mental health clinicians working together, can help identify and treat adolescent depression early. We explored systemic barriers to quality integrated care at the provincial level in Ontario, Canada using a learning system approach.</p><p><strong>Methods: </strong>Two Ontario Health Teams (OHTs), regional networks designed to support integrated care, completed the Practice Integration Profile (PIP) and participated in focus groups.</p><p><strong>Results: </strong>The OHTs had a median PIP score of 69 out of 100. Among the PIP domains, the lowest median score was case identification (50), and the highest one was workspace (100). The focus groups generated 180 statements mapped to the PIP domains. Workflow had the highest number of coded statements (59, 32.8%).</p><p><strong>Discussion: </strong>While the primary care practices included mental health clinicians on-site, the findings highlighted systemic barriers with adhering to the integrated care pathway for adolescent depression. These include limited access to mental health expertise for assessment and diagnosis, long wait times for treatment, and shortages of clinicians trained in evidence-based behavioral therapies. These challenges contributed to the reliance on antidepressants as the first line of treatment due to their accessibility rather than evidence-based guidelines.</p><p><strong>Conclusion: </strong>Primary care practices, within regional networks such as OHTs, can form learning systems to continuously identify the strategies needed to support quality integrated care for adolescent depression based on real-world data.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"6"},"PeriodicalIF":2.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681089","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":"Integrating Comprehensive Rehabilitation Care to Multimorbidity Approach: A Challenge for the Chilean Public Health System.","authors":"Paula Zamorano, Fernanda Calvo, Ricardo Banda, Javiera Fuentes, Clara Molina, Elena Medina, Marcela Gonzalez-Madrid","doi":"10.5334/ijic.7697","DOIUrl":"10.5334/ijic.7697","url":null,"abstract":"<p><p>The multimorbidity approach involves promotional and preventive strategies. The demand for rehabilitation services has grown exponentially in recent years, leading to the urgency of rethinking care delivery. In Chile, there are laws, programs, and guidelines that, from their theoretical basis, include a person-centered care focus. But in real practice, multiple barriers trigger important fragmentation of care. In response, a new strategy has been proposed to answer whether comprehensive rehabilitation care based on multimorbidity positively impacts the health system performance, people's functionality, and quality of life, which will be implemented as a pilot study with a national scale-up focus.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"7"},"PeriodicalIF":2.4,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681088","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":"Disentangling Population Health Management Initiatives in Diabetes Care: A Scoping Review.","authors":"Rose J Geurten, Jeroen N Struijs, Henk J G Bilo, Dirk Ruwaard, Arianne M J Elissen","doi":"10.5334/ijic.7512","DOIUrl":"10.5334/ijic.7512","url":null,"abstract":"<p><strong>Introduction: </strong>Population Health Management (PHM) focusses on keeping the whole population as healthy as possible. As such, it could be a promising approach for long-term health improvement in type 2 diabetes. This scoping review aimed to examine the extent to which and how PHM is used in the care for people with type 2 diabetes.</p><p><strong>Methods: </strong>PubMed, Web of Science, and Embase were searched between January 2000 and September 2021 for papers on self-reported PHM initiatives for type 2 diabetes. Eligible initiatives were described using the analytical framework for PHM.</p><p><strong>Results: </strong>In total, 25 studies regarding 18 PHM initiatives for type 2 diabetes populations were included. There is considerable variation in whether and how the PHM steps are operationalized in existing PHM initiatives. Population identification, impact evaluation, and quality improvement processes were generally part of the PHM initiatives. Triple Aim assessment and risk stratification actions were scarce or explained in little detail. Moreover, cross-sector integration is key in PHM but scarce in practice.</p><p><strong>Conclusion: </strong>Operationalization of PHM in practice is limited compared to the PHM steps described in the analytical framework. Extended risk stratification and integration efforts would contribute to whole-person care and further health improvements within the population.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"3"},"PeriodicalIF":2.6,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681081","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 and Social Care Integration in Scotland: Evidence vs Rhetoric.","authors":"Cam Donaldson, Peter Knight, Alastair L Noble, Sandy Strathearn","doi":"10.5334/ijic.7759","DOIUrl":"10.5334/ijic.7759","url":null,"abstract":"<p><p>In this perspective paper we use publicly-available data to show that, despite much positive rhetoric in support of reforms in Scotland to integrate health and social care, these reforms, in their current state, have failed to meet their stated objectives. Rather than regress to the previous system, we propose continued evaluation of even more radical forms of such integration. This analysis, and set of future proposals, are timely given current considerations with respect to a National Care Service in Scotland and recent similar reforms in England and in other countries.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"4"},"PeriodicalIF":2.4,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681083","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 Youth Service Preferences of Caregivers of Justice-Involved Youth: A Discrete Choice Conjoint Experiment.","authors":"Deanna F Klymkiw, David M Day, J L Henderson, Lisa D Hawke","doi":"10.5334/ijic.7044","DOIUrl":"10.5334/ijic.7044","url":null,"abstract":"<p><strong>Introduction: </strong>Mental health and/or substance use (MHS) challenges affect approximately 95% of youth in the criminal justice system, with only three in ten justice-involved youth receiving treatment. Caregivers of justice-involved youth have identified fragmented care as a barrier to youth accessing MHS services. One suggested solution to this problem is the implementation of integrated youth services (IYS). However, it is unknown which IYS components caregivers of justice-involved youth prioritize.</p><p><strong>Methods: </strong>Using a discrete choice conjoint experiment (DCE), <i>n</i> = 46 caregivers of justice-involved youth, and <i>n</i> = 204 caregivers of non-justice-involved, completed thirteen choice tasks representing different combinations of IYS.</p><p><strong>Results: </strong>Both caregiver groups exhibited preferences for involvement and access to information regarding their youth's treatment, and fast access to broad range of core health and additional services, in a community setting, with the incorporation of e-health services. Caregivers of justice-involved youth showed a unique preference for involvement in family counseling with their youth. The incorporation of this service feature may help to engage caregivers of justice-involved youth in their youths' MHS treatment 3-fold.</p><p><strong>Conclusion: </strong>Data gleaned from this analysis provides an understanding of what components of IYS models may help to engage caregivers of justice-involved youth.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"2"},"PeriodicalIF":2.4,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681087","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 Models for Older Adults with Depression and Physical Comorbidity: A Scoping Review","authors":"Laura Tops, Simon Gabriël Beerten, Mathieu Vandenbulcke, M. Vermandere, Mieke Deschodt","doi":"10.5334/ijic.7576","DOIUrl":"https://doi.org/10.5334/ijic.7576","url":null,"abstract":"Objective: Multimorbidity is a growing challenge in the care for older people with mental illness. To address both physical and mental illnesses, integrated care management is required. The purpose of this scoping review is to identify core components of integrated care models for older adults with depression and physical comorbidity, and map reported outcomes and implementation strategies. Methods: PubMed, EMBASE, CINAHL and Cochrane Library were searched independently by two reviewers for studies concerning integrated care interventions for older adults with depression and physical comorbidity. We used the SELFIE framework to map core components of integrated care models. Clinical and organisational outcomes were mapped. Results: Thirty-eight studies describing thirteen care models were included. In all care models, a multidisciplinary team was involved. The following core components were mainly described: continuity, person-centredness, tailored holistic assessment, pro-activeness, treatment interaction, individualized care planning, and coordination tailored to complexity of care needs. Twenty-seven different outcomes were evaluated, with more attention given to clinical than to organisational outcomes. Conclusion: The core components that comprise integrated care models are diverse. Future studies should focus more on implementation aspects of the intervention and describe financial parts, e.g., the cost of the intervention for the healthcare user, more transparently.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"6 12","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139439983","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":"Observational Data for Integrated Maternity Care: Experiences with a Data-Infrastructure for Parents and Children in the Netherlands","authors":"Zoë T. M. Scheefhals, E. F. de Vries, J. Molenaar, M. E. Numans, Jeroen N. Struijs","doi":"10.5334/ijic.7012","DOIUrl":"https://doi.org/10.5334/ijic.7012","url":null,"abstract":"Introduction: Observational data are increasingly seen as a valuable source for integrated care research. Especially since the growing availability of routinely collected data and quasi-experimental methods. The aim of this paper is to describe the potentials and challenges when using observational data for integrated maternity care research, based on our experience from developing and working with the Data-InfrAstructure for ParEnts and childRen (DIAPER). Methods and Results: We provide a description of DIAPER, which is a linked data-infrastructure on the individual level based on maternity care claims data, quality and utilization of maternity care and data from municipal registries, covering the life course from preconception to adulthood. We then discuss potentials and practical applications of DIAPER such as to evaluate alternative payment models for integrated maternity care, to set the policy agenda regarding postpartum care, to provide insights into value of care and into provider variation, and to evaluate (policy) interventions designed to promote and support integrated maternity care. This is relevant for several stakeholders: policy makers, payers, providers and clients/patients. Based on experiences with DIAPER, we identify remaining challenges: missing data sources (especially self-reported outcomes), suboptimal quality of data, privacy concerns and potential biases introduced during data linkage, and describe how these challenges were tackled within the applications of DIAPER. Conclusions: With DIAPER we demonstrated that using observational data can be of added value for integrated care research, but also that challenges remain. It is essential to keep exploring and developing the possibilities of observational data and continue the discussions in the scientific community. Learning from each other’s successes and failures will be critical.","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"5 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138954882","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}