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Toward Comprehensive Care Integration in Canada: Delphi Process Findings from Researchers, Clinicians, Patients and Decision Makers. 走向加拿大的全面护理一体化：研究人员、临床医生、患者和决策者的德尔菲过程研究结果。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27181
Émilie Dionne, Jeannie Haggerty, Catherine M Scott, Shelley Doucet, Tara Stewart, Amélie Quesnel-Vallée, William Montelpare, Robin Urquhart, Jason M Sutherland, Yves Couturier
{"title":"Toward Comprehensive Care Integration in Canada: Delphi Process Findings from Researchers, Clinicians, Patients and Decision Makers.","authors":"Émilie Dionne, Jeannie Haggerty, Catherine M Scott, Shelley Doucet, Tara Stewart, Amélie Quesnel-Vallée, William Montelpare, Robin Urquhart, Jason M Sutherland, Yves Couturier","doi":"10.12927/hcpol.2023.27181","DOIUrl":"10.12927/hcpol.2023.27181","url":null,"abstract":"<p><strong>Introduction: </strong>From a larger study examining policy and program information on how Canadian provinces integrate care services, this study aimed to create \"priority lists\" of 10-15 services that are \"absolutely needed\" for care integration.</p><p><strong>Methodology: </strong>A diverse group of over 50 Canadian stakeholders participated in virtual consensus-building using the nominal group technique and a modified e-Delphi method to identify services that focused on two different groups: children and youth with high functional health needs and older adults in functional decline.</p><p><strong>Results: </strong>Three lists - containing services, processes and infrastructure elements - emerged: one per tracer condition group and a consolidated list. The latter identified the following five services as top priority for primary care integration: mental health and addictions services; home care; transition between urgent-emergency-acute care; medication reconciliation in community pharmacies; and respite care. No single social service was a clear priority, but those that mitigate material deprivation emerged within the top 10.</p><p><strong>Discussion: </strong>This humble pan-Canadian study shows that priority services in health and social services are neither well integrated nor connected to primary care. It also suggests that effective policy strategizing for primary care integration for those with complex care needs may require thinking beyond the logic of services - given their siloed organization.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"24-38"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acknowledgment. 鸣谢。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27173
{"title":"Acknowledgment.","authors":"","doi":"10.12927/hcpol.2023.27173","DOIUrl":"10.12927/hcpol.2023.27173","url":null,"abstract":"","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"108-109"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Appendix 3: Program Implementation Data Collection Tool. 附录3：项目实施数据收集工具。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27185
{"title":"Appendix 3: Program Implementation Data Collection Tool.","authors":"","doi":"10.12927/hcpol.2023.27185","DOIUrl":"10.12927/hcpol.2023.27185","url":null,"abstract":"","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Connecting Health and Social Services for Patients with Complex Care Needs: A Pan-Canadian Comparative Policy Research Program. 为有复杂护理需求的患者提供医疗和社会服务：泛加拿大比较政策研究项目。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27182
Jeannie Haggerty, Catherine M Scott, Yves Couturier, AméLie Quesnel-Vallée, ÉMilie Dionne, Tara Stewart, Robin Urquhart, William Montelpare, Shelley Doucet, Nelly D Oelke
{"title":"Connecting Health and Social Services for Patients with Complex Care Needs: A Pan-Canadian Comparative Policy Research Program.","authors":"Jeannie Haggerty, Catherine M Scott, Yves Couturier, AméLie Quesnel-Vallée, ÉMilie Dionne, Tara Stewart, Robin Urquhart, William Montelpare, Shelley Doucet, Nelly D Oelke","doi":"10.12927/hcpol.2023.27182","DOIUrl":"10.12927/hcpol.2023.27182","url":null,"abstract":"<p><p>Comprehensive primary healthcare for patients with complex care needs requires connections to other health services, social services and community supports. This descriptive comparative policy research program used publicly available documents and informant interviews to examine progress toward integrated comprehensive care through the lens of services needed by children and youth (0-25 years) and community-dwelling older adults (≥ 65 years) with high functional health needs. This article describes five projects. The following three findings emerged across all the projects: Canada indeed has multiple health systems; numerous integrated service delivery solutions are being trialled and most focus on medical services; and it is an ongoing challenge for ministries of health to engage physicians and physician associations in integration.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"10-23"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient Partners Respond to High-Level Findings on the Connectedness of Health and Social Services across Canada. 患者合作伙伴对加拿大各地卫生和社会服务联系的高级别调查结果作出回应。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27175
Jeannie Haggerty, Catherine M Scott
{"title":"Patient Partners Respond to High-Level Findings on the Connectedness of Health and Social Services across Canada.","authors":"Jeannie Haggerty, Catherine M Scott","doi":"10.12927/hcpol.2023.27175","DOIUrl":"10.12927/hcpol.2023.27175","url":null,"abstract":"<p><p>This short article captures input from patient partners on the dimensions of the research program that most resonated with them. They are passionate about wanting to see a better connection between health and social services, and they are also willing to be involved as advisors for policy directions in the same way as their involvement has become the norm in any patient-oriented research.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"99-104"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Appendix 1: Macro Policy Data Collection Template. 附件1：宏观政策数据收集模板。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27186
{"title":"Appendix 1: Macro Policy Data Collection Template.","authors":"","doi":"10.12927/hcpol.2023.27186","DOIUrl":"10.12927/hcpol.2023.27186","url":null,"abstract":"","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lack of Publicly Available Documentation Limits Spread of Integrated Care Innovations in Canada. 缺乏公开的文件限制了综合护理创新在加拿大的传播。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27176
Tara Stewart, Émilie Dionne, Robin Urquhart, Nelly D Oelke, Jessie Lee Mcisaac, Catherine M Scott, Jeannie Haggerty
{"title":"Lack of Publicly Available Documentation Limits Spread of Integrated Care Innovations in Canada.","authors":"Tara Stewart, Émilie Dionne, Robin Urquhart, Nelly D Oelke, Jessie Lee Mcisaac, Catherine M Scott, Jeannie Haggerty","doi":"10.12927/hcpol.2023.27176","DOIUrl":"10.12927/hcpol.2023.27176","url":null,"abstract":"<p><p>As healthcare in Canada is provincially operated, the program innovations in one jurisdiction may not be readily known in other jurisdictions. We examine the availability of implementation-specific data for 30 innovative Canadian programs designed to integrate health and social services for patients with complex needs. Using publicly available data and key informant interviews, we were able to populate only ∼50% of our data collection tool (on average). Formal program evaluations were available for only ∼30% of programs. Multiple barriers exist to the compilation and verification of healthcare programs' implementation data across Canada, limiting cross-jurisdictional learning and making a comparison of programs challenging.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"88-98"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The team. 团队。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27174
{"title":"The team.","authors":"","doi":"10.12927/hcpol.2023.27174","DOIUrl":"10.12927/hcpol.2023.27174","url":null,"abstract":"","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"105-107"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Appendix 4. Program Integration Rating Tool. 附录4。程序集成评级工具。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27184
{"title":"Appendix 4. Program Integration Rating Tool.","authors":"","doi":"10.12927/hcpol.2023.27184","DOIUrl":"10.12927/hcpol.2023.27184","url":null,"abstract":"","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inconsistent Governance Structures for Health and Social Services Limit Service Integration for Patients with Complex Care Needs. 卫生和社会服务的治理结构不一致，限制了有复杂护理需求的患者的服务整合。
Healthcare Policy Pub Date : 2023-10-01 DOI: 10.12927/hcpol.2023.27180
Catherine M Scott, Jeannie Haggerty, Yves Couturier, Amélie Quesnel-Vallée, Tara Stewart, Émilie Dionne
{"title":"Inconsistent Governance Structures for Health and Social Services Limit Service Integration for Patients with Complex Care Needs.","authors":"Catherine M Scott, Jeannie Haggerty, Yves Couturier, Amélie Quesnel-Vallée, Tara Stewart, Émilie Dionne","doi":"10.12927/hcpol.2023.27180","DOIUrl":"10.12927/hcpol.2023.27180","url":null,"abstract":"<p><p>This paper describes how health and social services are governed and organized across Canada for two patient groups. Governance configurations and governance proximity between primary care and priority health and social services varied markedly between provinces. While the need for integrated service delivery has been made a clear priority during the COVID-19 pandemic, the potential of Canada's healthcare systems has not yet translated into coordinated and integrated care for health services, much less for health and social services. It is time to act on the policy recommendations from commissioned reports over the past two decades that focus on comprehensive, community-based care.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 SP","pages":"39-52"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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