scholarly journals Evaluating integrated care for people with complex needs

2020 ◽  
Vol 26 (1) ◽  
pp. 46-53
Author(s):  
Panagiotis Kasteridis ◽  
Anne Mason ◽  
Andrew Street
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Models Of Care ◽  
Care Team ◽  
Future Research ◽  
Complex Care ◽  
Care Needs ◽  
Complex Needs ◽  
Care Models ◽  
Integrated Care Models

Objectives As part of the Vanguard programme, two integrated care models were introduced in South Somerset for people with complex care needs: the Complex Care Team and Enhanced Primary Care. We assessed their impact on a range of utilization measures and mortality. Methods We used monthly individual-level linked primary and secondary care data from April 2014 to March 2018 to assess outcomes before and after the introduction of the care models. The analysis sample included 564 Complex Care Team and 841 Enhanced Primary Care cases that met specific criteria. We employed propensity score methods to identify out-of-area control patients and difference-in-differences analysis to isolate the care models’ impact. Results We found no evidence of significantly reduced utilization in any of the Complex Care Team or Enhanced Primary Care cohorts. The death rate was significantly lower only for those in the first Enhanced Primary Care cohort. Conclusions The integrated care models did not significantly reduce utilization nor consistently reduce mortality. Future research should test longer-term outcomes associated with the new models of care and quantify their contribution in the context of broader initiatives.

scholarly journals Primary Care and Mental Health: Overview of Integrated Care Models

2020 ◽  
Author(s):  
Margaret Brown ◽  
Catherine A. Moore ◽  
Jill MacGregor ◽  
Jason R. Lucey
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Integrated Care ◽  
Care Models ◽  
Integrated Care Models

scholarly journals Integrated healthcare models for rheumatoid arthritis: A descriptive systematic review

2019 ◽  
Vol 22 (1) ◽  
pp. 10-18
Author(s):  
Valentina Vodopivec ◽  
Hubertus JM Vrijhoef
Keyword(s):  
Rheumatoid Arthritis ◽  
Integrated Care ◽  
Patient Empowerment ◽  
Building Blocks ◽  
Models Of Care ◽  
Modern Approach ◽  
Experience Of Care ◽  
Care Models ◽  
Patients Experience ◽  
Integrated Care Models

Introduction Integrated people-centred care is a modern approach for addressing healthcare issues related to demographic changes, increasing prevalence of chronic diseases, and restricted resources. By providing an overview of integrated care models for patients with rheumatoid arthritis, we aimed to offer insight into the strategies and interventions that are being used for designing and implementing integrated models of care for this patient group, and their outcomes. Methods We conducted a systematic literature search of peer-reviewed literature available in English and published between 2013 and 2018, using three databases: Cochrane, PubMed and EMBASE. We analysed the publications based on the Framework on integrated people-centred health services and the Triple/Quadruple Aim framework. Results We identified 1271 records. After screening, 50 articles met the criteria for inclusion in the review. Approaches for improving patient empowerment, engagement and experience of care were most prevalent in the identified care profiles. Similarly, frequently reported outcomes were related to improvements in patients’ experience of care and their health status. Most of the studies we reviewed did not demonstrate notable improvements from the perspective of cost-effectiveness or benefits for the healthcare workforce. Conclusions Our findings suggest that for rheumatoid arthritis, integrated care is in the early stages of development. Strategies focusing on patient outcomes and patient satisfaction were found to be prioritised. Future initiatives aiming to redesign rheumatology care should adopt systems thinking perspective to better address all of the building blocks of people-centred integrated care.

Unmet Behavioral Health and Social Needs of Home Healthcare Patients and Their Caregivers

2021 ◽  
pp. 108482232110028
Author(s):  
Angela M. Gerolamo ◽  
Monika Pogorzelska-Maziarz ◽  
Alexzandra Gentsch ◽  
Ashley Traczuk ◽  
TingAnn Hsiao ◽  
...  
Keyword(s):  
Behavioral Health ◽  
Integrated Care ◽  
Public Health Problem ◽  
Social Needs ◽  
Home Healthcare ◽  
Health Needs ◽  
Future Research ◽  
Structured Interviews ◽  
Care Models ◽  
Integrated Care Models

Lack of recognition and treatment of mental health disorders in the home healthcare (HHC) population has been recognized as a national public health problem. However, there is a gap in understanding the behavioral health needs of HHC patients and caregivers from the perspectives of HHC patients, caregivers, and HHC personnel. These perspectives are critical for informing an acceptable and scalable integrated care model. We conducted semi-structured interviews with HHC patients, caregivers, and HHC personnel to assess the unmet behavioral health needs of HHC patients and their caregivers. Participants were recruited from a Medicare-certified HHC agency that is part of a large health system on the east coast. We completed a total of 31 interviews between January and May 2020. Findings suggest that HHC patients have significant unmet behavioral health and social needs and their caregivers are emotionally and physically drained. Reasons that patients may not be receiving adequate behavioral health services include denial, cost, culture, lack of awareness of available resources, lack of transportation, and homebound status. While most patients discussed the emotional toll of their illness, few were connected to services. HHC personnel offered suggestions on how to meet the behavioral health needs of patients, with the primary focus on providing in-home options. Gaps in meeting the needs of the HHC population necessitate integrated care models that can effectively address the behavioral health and social needs of HHC patients and their families. Future research should develop and test patient and caregiver-directed integrated care models in the HHC setting.

The Treatment of Schizophrenia Spectrum and Other Psychotic Disorders in Integrated Primary Care

2017 ◽  
Author(s):  
Elizabeth Lowdermilk ◽  
Nicole Joseph ◽  
Robert E Feinstein
Keyword(s):  
Primary Care ◽  
Best Practices ◽  
Integrated Care ◽  
Psychotic Disorders ◽  
Psychiatric Care ◽  
Lessons Learned ◽  
Care Model ◽  
Schizophrenia Spectrum ◽  
Care Models ◽  
Integrated Care Models

Many patients with psychotic disorders, for systemic and personal reasons, are treated in primary care, even though there currently are no evidence-based integrated care models supporting this practice. This chapter describes the screening and salient clinical features of schizophrenia and psychotic disorders, management of emergencies, the biopsychosocial-cultural evaluation, differential diagnosis (medical and psychiatric), and medications and other treatments that can be delivered by an integrated multidisciplinary team. Psychiatric specialty services are also described, so that primary care referrals to specialty psychiatric services can be offered. Special considerations are outlined for the care and treatment of psychotic women and psychotic geriatric populations. The Denver Health Medical Center’s model of integrated care is introduced, including lessons learned during its development and implementation. An integrated care model for the treatment of psychotic disorders in primary care is proposed that unites best practices of specialty psychiatric care with the fundamentals of integrated care.

scholarly journals Care programs and their components for patients with idiopathic pulmonary fibrosis: a systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anouk Delameillieure ◽  
Sarah Vandekerkhof ◽  
Bastiaan Van Grootven ◽  
Wim A. Wuyts ◽  
Fabienne Dobbels
Keyword(s):  
Systematic Review ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Integrated Care ◽  
Clinical Care ◽  
Multidisciplinary Care ◽  
Models Of Care ◽  
Management Support ◽  
Care Needs ◽  
Care Models

Abstract Background The multidimensional and complex care needs of patients with idiopathic pulmonary fibrosis (IPF) call for appropriate care models. This systematic review aimed to identify care models or components thereof that have been developed for patients with IPF in the outpatient clinical care, to describe their characteristics from the perspective of chronic integrated care and to describe their outcomes. Methods A systematic review was conducted using state-of-the-art methodology with searches in PubMed/Medline, Embase, CINAHL and Web Of Science. Researchers independently selected studies and collected data, which were described according to the Chronic Care Model (CCM). Results Eighteen articles were included describing 13 new care models or components. The most commonly described CCM elements were ‘delivery system design’ (77%) and ‘self-management support’ (69%), with emphasis on team-based and multidisciplinary care provision and education. The most frequently described outcome was health-related quality of life. Conclusions Given the high need for integrated care and the scarcity and heterogeneity of data, developing, evaluating and implementing new models of care for patients with IPF and the comprehensive reporting of these endeavours should be a priority for research and clinical care.

scholarly journals Increasing the Focus on Children's Complex and Integrated Care Needs: A Position Paper of the European Academy of Pediatrics

2021 ◽  
Vol 9 ◽  
Author(s):  
Maria Brenner ◽  
Josephine Greene ◽  
Carmel Doyle ◽  
Berthold Koletzko ◽  
Stefano del Torso ◽  
...  
Keyword(s):  
Integrated Care ◽  
Care Delivery ◽  
Complex Care ◽  
Care Needs ◽  
European Academy ◽  
Complex Needs ◽  
Health And Social Care ◽  
Multidisciplinary Working ◽  
Initial Work ◽  
Effective Development

There is wide variation in terminology used to refer to children living with complex needs, across clinical, research and policy settings. It is important to seek to reconcile this variation to support the effective development of programmes of care for this group of children and their families. The European Academy of Pediatrics (EAP) established a multidisciplinary Working Group on Complex Care and the initial work of this group examined how complex care is defined in the literature. A scoping review was conducted which yielded 87 papers with multiple terms found that refer to children living with complex needs. We found that elements of integrated care, an essential component of care delivery to these children, were repeatedly referred to, though it was never specifically incorporated into a term to describe complex care needs. This is essential for practice and policy, to continuously assert the need for integrated care where a complex care need exists. We propose the use of the term Complex and Integrated Care Needs as a suitable term to refer to children with varying levels of complexity who require continuity of care across a variety of health and social care settings.

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