Schlüsselwörter
(Englisch)
|
Integrated care; service delivery coordination; frail patients; elderly; medicine; management.
|
Forschungsprogramme
(Englisch)
|
COST-Action IS0903 - Enhancing the Role of Medicine in the Management of European Health Systems: Implications for Control, Innovation and User Voice
|
Kurzbeschreibung
(Englisch)
|
With the rising number of vulnerable groups who experience difficulties accessing the whole range of needed health and social services, «integrated care» has become a relevant component of health and social care programs and reforms across Europe and North America. However, any reform or project aimed to provide integrated models of care faces implementation issues such as cultural clashes (e.g., medicine vs. management, health vs. social care), service provisioning fragmentation, etc. The evaluation literature in this field showed inconsistent results in terms of efficiency and effectiveness: we argue that this is mainly due to the inherent context-dependence of the initiatives and complementarities among adopted operating means. An aspect of the utmost interest concerns the new role of the medical profession (e.g., specialists, general practitioners) within the new patient-centric models of care found in relevant best practices. The project aims to build on the extant literature and case-studies from different contexts (Switzerland, Italy, Canada, United States) to define relevant quali-quantitative typologies aimed to orient evaluation research and provide guidelines for decision makers.
|
Weitere Hinweise und Angaben
(Englisch)
|
Full name of research-institution/enterprise: Università della Svizzera Italiana USI Facoltà di scienze economiche Istituto di Microeconomia e Economia Pubblica (MecoP)
|
Partner und Internationale Organisationen
(Englisch)
|
BE, CH, CZ, DE, DK, EL, ES, FI, FR, HU, IL, IT, MK, NL, NO, PL, PT, SE, SI, UK
|
Abstract
(Englisch)
|
Western developed countries have been facing a population-ageing trend that is projected to en-large and deepen. The median age of the EU27 total population expected to increase from 40.4 to 47.9 years between 2008 and 2060 [1]. The elderly, currently absorbing 34-47% of healthcare ex-penditures in OECD countries [2], are going to grow among those vulnerable groups who experi-ence difficulties accessing appropriate health and social services across care settings. In Europe and North America «integrated care» has become a relevant component of healthcare programs and reforms to cope with a changing epidemiology. Strategies aim to enhance coordina-tion across care settings by means of a number of organizational models and techniques to foster prevention, rehabilitation and downward substitution of services for frail patients [3]. However, although integration is assumed to improve both efficiency and effectiveness of care, the evaluation literature in this field shows inconsistent results. We argue that inconsistencies are main-ly due to the inherent context-dependence of strategies and complementarities among the adopted operating means. In fact, any initiative aimed to provide integrated care faces implementation issues such as institutional fragmentation, cultural clashes (e.g., medicine vs. management, health vs. social care), providers’ competition over financial resources, barriers to information sharing. An aspect of the utmost interest concerns the new role of the medical profession within new patient-centric models of care: best practices suggest that soft variables, such as leadership, can challenge the “silos” of health systems (e.g., acute care, primary care, community care). The project focuses on frail elderly patients and aims to build on the extant literature and multiple case-studies (comparing advanced experiences in four countries) to define relevant typologies and a comprehensive explanatory framework aimed to orient further evaluation research, and provide decision makers with useful guidelines to manage the complexity belonging to caring for the needs of this target population. 1. Giannakouris K. Ageing characterises the demographic perspectives of the European societies. Luxembourg: Eurostat; 2008. 2. WHO. Preventing Chronic Diseases. A Vital Investment: WHO Global Report; 2005. 3. MacAdam The project focuses on frail elderly patients. It aims to build on the extant literature and empirical analyses to define an explanatory framework aimed to orient further evaluation research. In addition, it will provide decision makers with useful guidelines to manage the complexity belonging to caring for the needs of this target population. 1. Giannakouris K. (2008). Ageing characterises the demographic perspectives of the European societies. Luxembourg: Eurostat; 2008. 2. WHO. (2005) Preventing Chronic Diseases. A Vital Investment: WHO Global Report. 3. Ahmed S. et al. (2009). 'Changing health care: Stakeholders perceptions of the burden of chronic disease and the value of teams, measurements and communication.' Healthcare Quarterly 12(2): e1-e13. 4. MacAdam M. (2008). Frameworks of Integrated Care for the Elderly: A Systematic Review. CPRN Research Report.
|
Datenbankreferenzen
(Englisch)
|
Swiss Database: COST-DB of the State Secretariat for Education and Research Hallwylstrasse 4 CH-3003 Berne, Switzerland Tel. +41 31 322 74 82 Swiss Project-Number: C10.0099
|
