scholarly journals Validation of the care providers version of the Rainbow Model of Integrated Care-measurement tool in Chinese primary care systems

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yixiang Huang ◽  
Paiyi Zhu ◽  
Lijin Chen ◽  
Xin Wang ◽  
Pim Valentijn
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Measurement Tool ◽  
Care Providers ◽  
Care Systems

scholarly journals Validation of the care providers version of the Rainbow Model of Integrated Care-Measurement Tool in Chinese primary care systems

2020 ◽  
Author(s):  
Yixiang Huang ◽  
Paiyi Zhu ◽  
Lijin Chen ◽  
Xin Wang ◽  
Pim Valentijn
Keyword(s):  
Primary Care ◽  
Factor Analysis ◽  
Psychometric Properties ◽  
Integrated Care ◽  
Exploratory Factor Analysis ◽  
Internal Consistency ◽  
Internal Consistency Reliability ◽  
Measurement Tool ◽  
Adaptation Process ◽  
Care Systems

Abstract Background: The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. To translate and adapt the original care provider version of the RMIC-MT and evaluate its psychometric properties by a pilot study in Chinese primary care systems.Methods: The translation and adaptation process were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 1610 community care professionals in all 79 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method and promax rotation was used to assess the construct validity. Cronbach’s alpha was utilized to ascertain the internal consistency reliability. Lastly, confirmation factor analysis was used to evaluate the exploratory factor analysis model fit.Results: During the translation and adaptation process, all 48 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Six factors (person- & community-centeredness, care integration, professional integration, organizational integration, cultural competence and technical competence) with 45 items were determined by exploratory factor analysis, accounting for 61.46% of the total variance. A standard Cronbach’s alpha of 0.940 and significant correlation among all items in the scale (>0.4) showed good internal consistency reliability of the tool. And, the model passed the majority of goodness-to-fit test by confirmation factor analysis Conclusions: The results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT provider version. Its application in China will promote the development of people-centered integrated primary care. However, further psychometric testing is needed in multiple primary care settings with both public and private community institutes.

scholarly journals Validation of the care providers version of the Rainbow Model of Integrated Care-Measurement Tool in Chinese primary care systems

2020 ◽  
Author(s):  
Yixiang Huang ◽  
Paiyi Zhu ◽  
Lijin Chen ◽  
Xin Wang ◽  
Pim Valentijn
Keyword(s):  
Primary Care ◽  
Factor Analysis ◽  
Psychometric Properties ◽  
Integrated Care ◽  
Exploratory Factor Analysis ◽  
Care Provider ◽  
Internal Consistency Reliability ◽  
Measurement Tool ◽  
Adaptation Process ◽  
Care Systems

Abstract Background: The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care, which provides a comprehensive theoretical framework for integrated care. To translate and adapt the original care provider version of the Rainbow Model of Integrated Care-Measurement Tool and evaluate its psychometric properties by a pilot study in Chinese primary care systems.Methods: The translation and adaptation process were performed in four steps, forward and back-translation, expert review and pre-testing. We conducted a cross-sectional study with 1610 community care professionals in all 79 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method and promax rotation was used to assess the construct validity. Pearson’s correlation was used to assess concurrent validity. Cronbach’s alpha was utilized to ascertain the internal consistency reliability. Lastly, confirmation factor analysis was used to evaluate the exploratory factor analysis model fit.Results: During the translation and adaptation process, all 55 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Eight factors were determined by exploratory factor analysis, accounting for 66.41% of the total variance. According to exploratory factor analysis and discussion with all authors, the original ten dimensions were adjusted to nine dimensions in the Chinese version. A standard Cronbach’s alpha of 0.960 and significant correlation among all items in the scale (>0.4) showed good internal consistency reliability of the tool. And, the model passed the majority of goodness-to-fit test by confirmation factor analysis Conclusions: The results showed initial satisfactory psychometric properties for the validation of the RMIC-MT care provider version. Its application in China will promote the development of people-centered integrated primary care. However, further psychometric testing is needed in multiple primary care settings with both public and private community institutes.

scholarly journals Mental Health and Primary Care: Contributing to Mental Health System Transformation in Canada

2017 ◽  
Vol 36 (4) ◽  
pp. 33-67 ◽  
Author(s):  
Nick Kates
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Health Providers ◽  
Care Providers ◽  
System Transformation ◽  
Mental Health Systems ◽  
Care Systems

For 20 years mental health and primary care providers across Canada have been working collaboratively together to improve access to care, provider skills, and patient experience. The new strategic plan of the Mental Health Commission of Canada (MHCC) offers many opportunities for collaborative care to play a role in the transformation of Canada’s mental health systems. To assist the plan, this paper presents principles underlying successful projects and ways that mental health and primary care services can work together more collaboratively, including integrating mental health providers in primary care. It integrates these concepts into a Canadian Model for Collaborative Mental Health Care that can guide future expansion of these approaches, and suggests ways in which better collaboration can address wider issues facing all of Canada’s health care systems.

Why care about integrated care? Part 2. Integrated care systems: an irresistible force changing mental health services

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Derek K. Tracy ◽  
Frank Holloway ◽  
Kara Hanson ◽  
Nikita Kanani ◽  
Matthew Trainer ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Integrated Care ◽  
Healthcare Delivery ◽  
Local Implementation ◽  
The Past ◽  
Care Systems

SUMMARY Part 1 of this three-part series on integrated care discussed the drivers for change in healthcare delivery in England set out in the NHS Long Term Plan. This second part explores the evolution of mental health services within the wider National Health Service (NHS), and describes important relevant legislation and policy over the past decade, leading up to the 2019 Long Term Plan. We explain the implications of this, including the detail of emerging structures such as integrated care systems (ICSs) and primary care networks (PCNs), and conclude with challenges facing these novel systems. Part 3 will address the practical local implementation of integrated care.

Heart Failure Integrated Care Project: overcoming barriers encountered by primary health care providers in heart failure management

2020 ◽  
Vol 44 (3) ◽  
pp. 451
Author(s):  
Victar Hsieh ◽  
Glenn Paull ◽  
Barbara Hawkshaw
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
General Practice ◽  
Integrated Care ◽  
Significant Proportion ◽  
Primary Care Providers ◽  
Care Providers ◽  
Care Model ◽  
Care Project ◽  
Effective Delivery

ObjectiveHeart failure (HF) is associated with increased morbidity and mortality. A significant proportion of HF patients will have repeated hospital presentations. Effective integration between general practice and existing HF management programs may address some of the challenges in optimising care for this complex patient population. The Heart Failure Integrated Care Project (HFICP) investigated the barriers encountered by primary healthcare providers in providing care to patients with HF in the community. MethodsFive general practices in the St George and Sutherland regions (NSW, Australia) that employed practice nurses (PNs) were enrolled in the project. Participants responded to a printed survey that asked about their perceived role in the management of HF patients and their current knowledge and confidence in managing this condition. Participants also took part in a focus group meeting and were asked to identify barriers to improving HF patient management in general practice, and to offer suggestions about how the project could assist them to overcome those barriers. ResultsBarriers to effective delivery of HF management in general practice included clinical factors (consultation time limitations, underutilisation of patient management systems, identifying patients with HF, lack of patient self-care materials), professional factors (suboptimal hospital discharge summary letters, underutilisation of PNs), organisation factors (difficulties in communication with hospital staff, lack of education regarding HF management) and system issues (no Medicare rebate for B-type natriuretic peptide testing, insufficient Medicare rebate for using PN in chronic disease management). ConclusionsThe HFICP identified several barriers to improving integrated management for HF patients in the Australian setting. These findings provide important insights into how an HF integrated care model can be implemented to strengthen the working relationship between hospitals and primary care providers in delivering better care to HF patients. What is known about the topic?Multidisciplinary HF programs are heterogeneous in their structures, they have low patient participation rates and a significant proportion of HF patients have further presentations to hospital with HF. Integrating the care of HF patients into the primary care system following hospital admission remains challenging. What does this paper add?This paper identified several factors that hinder the effective delivery of care by primary care providers to patients with HF. What are the implications for practitioners?The findings provide important insights into how an HF integrated care model can be implemented to strengthen the working relationship between tertiary health facilities and primary care providers in delivering better care to HF patients.

Satisfaction with Primary Health Care and Confidence in General Practitioners: An Exploratory Comparison of US and UK Students

1993 ◽  
Vol 6 (2) ◽  
pp. 89-98
Author(s):  
Bodo B. Schlegelmilch ◽  
James M. Carman
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Health ◽  
The Us ◽  
Care Systems ◽  
The Uk ◽  
Oriented System

This paper explores attitudes of university students towards two differently organised health services, ie the National Health Service in the UK and the more market oriented system in the US and analyses the level of confidence placed in primary care providers (GPs/family physicians) in both systems. Although major differences in the perception of the two health care systems are identified, hardly any differences emerge between the two countries in terms of the confidence patients place in their primary care providers.

scholarly journals Seeking Care for Hyperglycemia in the Emergency Department: Through the Eyes of the Patient

2020 ◽  
Author(s):  
Justin W. Yan ◽  
Dimah Azzam ◽  
Melanie P. Columbus ◽  
Kristine Van Aarsen ◽  
Selina L. Liu ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Emergency Department ◽  
Hospital Admission ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Urgent Care ◽  
Care Providers ◽  
Health Care Settings ◽  
Care Systems

Health care systems often provide a range of options of care for patients with illnesses who do not require hospital admission. For individuals with diabetes, these options may include primary care providers, specialized diabetes clinics, and urgent care and walk-in clinics. We explored the reasons why patients choose the Emergency Department over other health care settings when seeking care for hyperglycemia.

scholarly journals Integrated Care for Depression in Older Primary Care Patients

2018 ◽  
Vol 63 (7) ◽  
pp. 439-446 ◽  
Author(s):  
Martha L. Bruce ◽  
Jo Anne Sirey
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Integrated Care ◽  
Primary Care Providers ◽  
Multidisciplinary Teams ◽  
Depression Treatment ◽  
Care Providers ◽  
Number Of Patients ◽  
Challenges And Opportunities ◽  
Effective Models

For decades, depression in older adults was overlooked and not treated. Most treatment was by primary care providers and typically poorly managed. Recent interventions that integrate mental health services into primary care have increased the number of patients who are treated for depression and the quality of that treatment. The most effective models involve systematic depression screening and monitoring, multidisciplinary teams that include primary care providers and mental health specialists, a depression care manager to work directly with patients over time and the use of guideline-based depression treatment. The article reviews the challenges and opportunities for providing high-quality depression treatment in primary care; describes the 3 major integrated care interventions, PRISM-E, IMPACT, and PROSPECT; reviews the evidence of their effectiveness, and adaptations of the model for other conditions and settings; and explores strategies to increase their scalability into real world practice.

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