Social Features of Integration in Health Systems and Their Relationship to Provider Experience, Care Quality and Clinical Integration

2021 ◽  
pp. 107755872110247
Author(s):  
Michaela Kerrissey ◽  
Maike Tietschert ◽  
Zhanna Novikov ◽  
Hassina Bahadurzada ◽  
Anna D. Sinaiko ◽  
...  

More is known about the structural features of health system integration than the social features—elements of normative integration (alignment of norms) and interpersonal integration (collaboration among professionals and with patients). We surveyed practice managers and 1,360 staff and physicians at 59 practice sites within 17 health systems (828 responses; 61%). Building on prior theory, we developed and established the psychometric properties of survey measures describing normative and interpersonal integration. Normative and interpersonal integration were both consistently related to better provider experience, perceived care quality, and clinical integration (e.g., a 1-point increase in a practice’s normative integration was associated with 0.53-point higher job satisfaction and 0.77-point higher perceived care quality in the practice, measured on 1 to 5 scales, p < .01). Variation in social features of integration may help explain why some health systems better integrate care, pointing to normative and interpersonal integration as potential resources for improvement.

Author(s):  
Peter Tsasis ◽  
Evans ◽  
Forrest ◽  
Jones

2015 ◽  
Vol 61 (4) ◽  
pp. 317-323
Author(s):  
Clara Carpeggiani ◽  
Alberto Macerata ◽  
Maria Aurora Morales

SummaryObjectives:the aim of this study was to report a ten years experience in the electronic medical record (EMR) use. An estimated 80% of healthcare transactions are still paper-based.Methods:an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity supported electronically, regarding 4,911 adult patients hospitalized in the 2004- 2008 period, was examined.Results:the final EMR product integrated multimedia document (text, images, signals). EMR presented for the most part advantages and was well adopted by the personnel. Appropriateness evaluation was also possible for some procedures. Some disadvantages were encountered, such as start-up costs, long time required to learn how to use the tool, little to no standardization between systems and the EMR technology.Conclusion:the EMR is a strategic goal for clinical system integration to allow a better health care quality. The advantages of the EMR overcome the disadvantages, yielding a positive return on investment to health care organization.


2007 ◽  
Vol 22 (2) ◽  
pp. 204-214 ◽  
Author(s):  
Manuela Pessanha ◽  
Cecília Aguiar ◽  
Joaquim Bairrão

2009 ◽  
Vol 25 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Lawrence D. Prybil ◽  
Richard Peterson ◽  
Paul Brezinski ◽  
Gideon Zamba ◽  
William Roach ◽  
...  

Author(s):  
Silvia Bruzzi ◽  
Enrico Ivaldi ◽  
Marta Santagata

AbstractGiven the regional disparities that historically characterize the Italian context, in this paper we propose a framework to evaluate the regional health care systems’ performance in order to contribute to the debate on the relationship between decentralisation of health care and equity. To investigate the regional health systems performance, we refer to the OECD Health Care Quality Indicators project to construct of a set of five composite indexes. The composite indexes are built on the basis of the non-compensatory Adjusted Mazziotta-Pareto Index, that allows comparability of the data across units and over time. We propose three indexes of health system performance, namely Quality Index, Accessibility Index and Cost-Expenditure Index, along with a Health Status Index and a Lifestyles Index. Our framework highlights that regional disparities still persist. Consistently with the evidence at the institutional level, there are regions, particularly in Southern Italy, which record lower levels of performance with high levels of expenditure. Continuous research is needed to provide policy makers with appropriate data and tools to build a cohesive health care system for the benefit of the whole population. Even if future research is needed to integrate our framework with new indicators for the calculation of the indexes and with the identification of new indexes, the study shows that a scientific reflection on decentralisation of health systems is necessary in order to reduce inequalities.


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