Journal of Integrated Care最新文献

{"title":"How can we define social care and what are the levels of true integration in integrated care? A narrative review","authors":"Gabriela Uribe, Ferdinand C. Mukumbang, C. Moore, Tabitha Jones, S. Woolfenden, K. Ostojic, P. Haber, J. Eastwood, James Gillespie, C. Huckel Schneider","doi":"10.1108/jica-08-2022-0045","DOIUrl":"https://doi.org/10.1108/jica-08-2022-0045","url":null,"abstract":"PurposeIntegrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.Design/methodology/approachA narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.FindingsIn total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.Originality/valueThe authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73680791","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}

{"title":"How to handle gerontocracy","authors":"M. Canoy, Yvonne Krabbe, X. Koolman","doi":"10.1108/jica-07-2022-0036","DOIUrl":"https://doi.org/10.1108/jica-07-2022-0036","url":null,"abstract":"PurposeThe article demonstrates the dangers of gerontocracy and offers solutions.Design/methodology/approachThe article combines desk research, literature review and economic analytical reasoning.FindingsGerontocracy in developed countries is a threat to financial, labour market and political sustainability of care for older people. Without actions today, the problem will become bigger every year, not least because of increased electoral weight of older people. This article proposes to handle gerontocracy in two ways. First is by using the potential of healthy retired people as volunteers, thereby mitigating the intergenerational solidarity challenges. Second is by taxing part of the windfall profits on the housing market, where older generation profited disproportionally.Originality/valueThe added value of the article is twofold. First, it signals a serious problem in affluent societies that is largely ignored, both in the academic world and in politics. Second, it offers original solutions that mitigate the problem.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"34 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91276002","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}

{"title":"Integrated care systems and equity: prospects and plans","authors":"M. Goddard","doi":"10.1108/jica-08-2022-0044","DOIUrl":"https://doi.org/10.1108/jica-08-2022-0044","url":null,"abstract":"PurposePolicies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were confirmed in law in July 2022. One of the four fundamental purposes of ICSs is to tackle health inequalities. This paper reports on the content of the overarching ICS plans in order to explore how they focus on health inequalities and the strategies they intend to employ to make progress. It explores how the integrated approach of ICSs may help to facilitate progress on equity.Design/methodology/approachThe analysis is based on a sample of 23 ICS strategic plans using a framework to extract relevant information on health inequalities.FindingsThe place-based nature of ICSs and the focus on working across traditional health and care boundaries with non-health partners gives the potential for them to tackle not only the inequalities in access to healthcare services, but also to address health behaviours and the wider social determinants of health inequalities. The plans reveal a commitment to addressing all three of these issues, although there is variation in their approach to tackling the wider social determinants of health and inequalities.Originality/valueThis study adds to our knowledge of the strategic importance assigned by the new ICSs to tackling health inequalities and illustrates the ways in which features of integrated care can facilitate progress in an area of prime importance to society.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"23 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84549294","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}

{"title":"Editorial: Why changes in primary care will affect integrated care","authors":"A. Kaehne","doi":"10.1108/jica-02-2023-090","DOIUrl":"https://doi.org/10.1108/jica-02-2023-090","url":null,"abstract":"","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"12 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87188683","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}

{"title":"Shared leadership in integrated care networks: the case of “hub and spoke” networks in oral and maxillofacial surgery (OMFS) in the English NHS","authors":"S. Willcocks, Edward J Willcocks","doi":"10.1108/jica-11-2022-0058","DOIUrl":"https://doi.org/10.1108/jica-11-2022-0058","url":null,"abstract":"PurposeThe purpose of this paper is to explore leadership in the context of the hub and spoke network in oral and maxillofacial surgery (OMFS) in the English National Health Service (NHS).Design/methodology/approachThis paper is a conceptual paper using literature relating to the antecedents of shared leadership and relevant policy documents pertaining to both NHS policy and the development of OMFS. The paper is informed, theoretically by the conceptual lens of shared leadership.FindingsThe paper identifies the challenges that may be faced by policymakers and those involved in the hub and spoke network in developing shared leadership. It also reveals the implications for policymakers in developing shared leadership.Research limitations/implicationsThe paper is conceptual. It is acknowledged that this is a preliminary study and further work will be required to test the conceptual framework empirically. The paper discusses the policy implications of developing leadership in the hub and spoke network. As networks are of interest internationally this has wider relevance to other countries.Originality/valueThere is limited research on the antecedents of shared leadership. In addition, the conceptual framework is applied to a new policy context.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"61 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81867308","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}

{"title":"A co-production approach to exploring an integrated service model in UK local authorities","authors":"Parisa Diba, Jonathan Bowden, Andrew Divers, Beth Taylor, D. Newbury-Birch, Jonathan Ling","doi":"10.1108/jica-06-2022-0031","DOIUrl":"https://doi.org/10.1108/jica-06-2022-0031","url":null,"abstract":"PurposeIntegrated service models aim to simplify access, enable effective delivery, remove duplication and provide a holistic and person-centred approach. This project explored the development of integrated well-being services in two local authorities in North-East England. The purpose of this paper is to address this issue.Design/methodology/approachUnderpinned by public health and co-production approaches, the project utilised a mixed-methods approach. Data were collected via online surveys (n = 95), virtual interviews with members of the local population (n = 8) and practitioners and commissioners (n = 8) to explore needs for a new service. Thematic analysis was used to identify key themes and issues.FindingsSeveral benefits of an integrated service were highlighted by both staff and service users, with a central anticipated benefit being the provision of holistic care. Improvement in information sharing was also seen to increase the efficiency of services and communication barriers between services. Beneficial aspects and barriers related to the COVID-19 pandemic on current service provision were reported that have informed our future recommendations.Originality/valueThe authors’ findings provide a much deeper insight into function, care, social inclusion and ongoing support needs, from both the perspectives of staff and service users. Service users and staff saw value in an integrated model for themselves, as well as the wider community. The authors’ findings indicate that the integrated service model is a promising one for the development of services within local authorities.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"115 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78603767","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}

{"title":"Knowledge management in a regional integrated health and social care system","authors":"Tuomas Hujala, Harri Laihonen","doi":"10.1108/jica-06-2022-0032","DOIUrl":"https://doi.org/10.1108/jica-06-2022-0032","url":null,"abstract":"PurposeThis article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform and service integration as a knowledge management (KM) issue and analyse how KM appears and contributes in the context of integrated care, specifically in the process of integrating social and health care.Design/methodology/approachThe article analyses the case organisation's KM initiatives in light of the integrated care literature and recognises the tasks and requirements for effective KM when building integrated health and social care system. The empirical research material for this qualitative study consisted of the case organisation's strategy documents, the results of an external maturity assessment, KM workshop materials and publicly available documentation of the Finnish health and social care reform.FindingsThis study identifies the mechanisms by which KM can support health and social services integration. At the macro level, national coordination and regional co-operation require common information structures. At the meso level, a shared regional strategy with shared objectives guides both organisational decision-making and collaboration between professionals. At the micro level, technology supported and data-driven planning of service chains complements the experiences of professionals and may help remove obstacles to integration.Originality/valueThis study contributes to the literature on integrated care by providing a more comprehensive view of the role and tasks of knowledge and KM when reforming health and social services than approaches focussing solely on health informatics and internal efficiency.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"114 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87942936","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}

{"title":"Priorities in integrating primary and secondary care: a multimethod study of GPs","authors":"S. Dunlea, G. McCombe, J. Broughan, Áine Carroll, R. Fawsitt, J. Gallagher, Kyle Melin, W. Cullen","doi":"10.1108/jica-06-2022-0030","DOIUrl":"https://doi.org/10.1108/jica-06-2022-0030","url":null,"abstract":"PurposeThroughout the world, healthcare policy has committed to delivering integrated models of care. The interface between primary–secondary care has been identified as a particularly challenging area in this regard. To that end, this study aimed to examine the issue of integrated care from general practitioners’ (GPs) perspectives in Ireland.Design/methodology/approachThis multimethod study involved a cross-sectional survey and semi-structured interviews with GPs in the Ireland East region. A total of 1,274 GPs were identified from publicly available data as practising in the region, of whom the study team were able to identify 430 GPs with email addresses. An email invite was sent to 430 potential participants asking them to complete a 34-item online questionnaire and, for those who were willing, an in-depth interview was conducted with a member of the study team.FindingsIn total, 116 GPs completed the survey. Most GPs felt that enhancing integration between primary and secondary care in Ireland was a priority (n = 109, 93.9%). Five themes concerning the state of integrated care and initiatives to improve matters were identified from semi-structured interviews with 12 GPs.Originality/valueThe uniqueness of this study is that it uses a multimethod approach to provide insight into current GP views on the state of integrated care in Ireland, as well as their perspectives on how to improve integration within the Irish healthcare system.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"21 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84503645","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}

{"title":"Perceptions towards integrated care through the narrative of practicing social workers and psychologists in PHC: a cross-case analysis","authors":"N. Ryapolova, J. Galea, Karah Y. Greene","doi":"10.1108/jica-08-2022-0042","DOIUrl":"https://doi.org/10.1108/jica-08-2022-0042","url":null,"abstract":"PurposeIn a collective effort to build a patient-centered and coordinated health care system, social workers and psychologists are being progressively introduced to primary health care (PHC) settings worldwide. The present study aims to explore the current status of integration through the narrative of social workers and psychologists in PHC settings in Kazakhstan.Design/methodology/approachIn this paper purposive snowball sampling was utilized to recruit social workers and psychologists who work, or used to work, in PHC settings since the onset of integration in Nur-Sultan for participation in an in-depth interview. A semistructured interview guide was based on normalization process theory (NPT). Interviews were conducted via video conference, in Russian language, lasted no more than 50 min, and transcribed verbatim. Cross-case analysis of eight cases was performed using NPT constructs.FindingsCross-case analysis included findings from the interviews from five social workers and three psychologists. Four major constructs of implementation process from NPT were reflected in the findings: coherence (believes integration improves patient care, functions within integrated care), cognitive participation (individual changes to role performance, mechanisms of work), collective action (status of support from stakeholders, cooperation within a multidisciplinary team) and reflective monitoring (existing mechanisms for monitoring the integration).Research limitations/implicationsDespite organizational integration, there is a lack of successful clinical integration of social workers and psychologists in PHC settings of Kazakhstan, which is manifested by a lack of understanding of responsibilities and functions of these mental health care specialists. Consensus was reached by all participants that both social workers and psychologists are valuable assets in a multidisciplinary team.Originality/valueThe present study contributes to the current knowledge of integrated PHC service delivery by addressing the status of integrated care in Kazakhstan from interviews with key stakeholders in social work and mental health. Moving forward, improvements are needed to (1) establish the monitoring mechanism to evaluate the status of integration, (2) enhance effective collaboration within multidisciplinary teams in PHC settings and (3) increase awareness among medical workers and community members on mental health issues and the available support offered by social workers and psychologists to promote quality of life in a holistic, integrated manner.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"58 2 Suppl 1 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77753243","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}

{"title":"Women living with HIV, diabetes and/or hypertension multi-morbidity in Uganda: a qualitative exploration of experiences accessing an integrated care service","authors":"M. Van Hout, F. Zalwango, Mathias Akugizibwe, Moreen Namulundu Chaka, C. Bigland, J. Birungi, S. Jaffar, M. Bachmann, J. Murdoch","doi":"10.1108/jica-06-2022-0033","DOIUrl":"https://doi.org/10.1108/jica-06-2022-0033","url":null,"abstract":"PurposeWomen experience a triple burden of ill-health spanning non-communicable diseases (NCDs), reproductive and maternal health conditions and human immunodeficiency virus (HIV) in sub-Saharan Africa. Whilst there is research on integrated service experiences of women living with HIV (WLHIV) and cancer, little is known regarding those of WLHIV, diabetes and/or hypertension when accessing integrated care. Our research responds to this gap.Design/methodology/approachThe INTE-AFRICA project conducted a pragmatic parallel arm cluster randomised trial to scale up and evaluate “one-stop” integrated care clinics for HIV-infection, diabetes and hypertension at selected primary care centres in Uganda. A qualitative process evaluation explored and documented patient experiences of integrated care for HIV, diabetes and/or hypertension. In-depth interviews were conducted using a phenomenological approach with six WLHIV with diabetes and/or hypertension accessing a “one stop” clinic. Thematic analysis of narratives revealed five themes: lay health knowledge and alternative medicine, community stigma, experiences of integrated care, navigating personal challenges and health service constraints.FindingsWLHIV described patient pathways navigating HIV and diabetes/hypertension, with caregiving responsibilities, poverty, travel time and cost and personal ill health impacting on their ability to adhere to multi-morbid integrated treatment. Health service barriers to optimal integrated care included unreliable drug supply for diabetes/hypertension and HIV linked stigma. Comprehensive integrated care is recommended to further consider gender sensitive aspects of care.Originality/valueThis study whilst small scale, provides a unique insight into the lived experience of WLHIV navigating care for HIV and diabetes and/or hypertension, and how a “one stop” integrated care clinic can support them (and their children) in their treatment journeys.","PeriodicalId":51837,"journal":{"name":"Journal of Integrated Care","volume":"227 12","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72541291","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}