scholarly journals Commissioning for coordinated care services using an outcomes based funding model: Insights from a process review

2021 ◽  
Vol 20 (3) ◽  
pp. 140
Author(s):  
Joanne Epp ◽  
Henry Cutler ◽  
Rachel Sheather-Reid ◽  
Peter Lewis ◽  
Anthony Critchley ◽  
...  
Keyword(s):  
Coordinated Care ◽  
Care Services ◽  
Funding Model ◽  
Outcomes Based Funding

scholarly journals The Primary Care Spend Model: a systems approach to measuring investment in primary care

2019 ◽  
Vol 4 (4) ◽  
pp. e001601 ◽  
Author(s):  
Robert Baillieu ◽  
Michael Kidd ◽  
Robert Phillips ◽  
Martin Roland ◽  
Michael Mueller ◽  
...  
Keyword(s):  
Primary Care ◽  
Health System ◽  
Systems Approach ◽  
Dynamic Assessment ◽  
International Health ◽  
Coordinated Care ◽  
Healthcare Budget ◽  
Care Services ◽  
Primary Care Services ◽  
Data Limitations

Increased investment in primary care is associated with lower healthcare costs and improved population health. The allocation of scarce resources should be driven by robust models that adequately describe primary care activities and spending within a health system, and allow comparisons within and across health systems. However, disparate definitions result in wide variations in estimates of spending on primary care. We propose a new model that allows for a dynamic assessment of primary care spending (PC Spend) within the context of a system’s total healthcare budget. The model articulates varied definitions of primary care through a tiered structure which includes overall spending on primary care services, spending on services delivered by primary care professionals and spending delivered by providers that can be characterised by the ‘4Cs’ (first contact, continuous, comprehensive and coordinated care). This unifying framework allows a more refined description of services to be included in any estimate of primary care spend and also supports measurement of primary care spending across nations of varying economic development, accommodating data limitations and international health system differences. It provides a goal for best accounting while also offering guidance, comparability and assessments of how primary care expenditures are associated with outcomes. Such a framework facilitates comparison through the creation of standard definitions and terms, and it also has the potential to foster new areas of research that facilitate robust policy analysis at the national and international levels.

scholarly journals Using visualisation methods to analyse referral networks within community health care among patients aged 65 years and over

2019 ◽  
Vol 26 (1) ◽  
pp. 354-375
Author(s):  
Ryan Palmer ◽  
Martin Utley ◽  
Naomi J Fulop ◽  
Stephen O’Connor
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Single Point ◽  
Community Health Care ◽  
Coordinated Care ◽  
Care Services ◽  
Referral Networks ◽  
Community Provider ◽  
Multiple Services

Community health care services are considered integral to overcoming future problems in health care. However, this sector faces its own challenges, such as how to organise services to provide coordinated care given: their physical distribution, patients using multiple services, increased patient use and differing patient needs. The aim of this work was to explore, analyse and understand patterns in community referrals for patients aged 65 years and over, and their use of multiple services through data visualisation. Working with a large community provider, these methods helped researchers and service managers to investigate questions that were otherwise difficult to answer from raw data. Each map focuses on a different characteristic of community referrals: patients reusing services, concurrent uses of different services and patterns of subsequent referrals. We apply these methods to routine patient data and discuss their implications in designing of a single point of access – a service for streamlining referrals.

Developing and utilising a new funding model for home-care services in New Zealand

2018 ◽  
Vol 26 (3) ◽  
pp. 345-355 ◽  
Author(s):  
Matthew Parsons ◽  
Paul Rouse ◽  
Laszlo Sajtos ◽  
Julie Harrison ◽  
John Parsons ◽  
...  
Keyword(s):  
New Zealand ◽  
Home Care ◽  
Home Care Services ◽  
Care Services ◽  
Funding Model

scholarly journals Editorial

1997 ◽  
Vol 3 (1) ◽  
pp. 5
Author(s):  
Heather Gardner
Keyword(s):  
Community Health ◽  
Community Health Services ◽  
Community Services ◽  
Coordinated Care ◽  
Community Based ◽  
Health Networks ◽  
Care Services ◽  
Functional Relations ◽  
Community Health Networks ◽  
General Care

How should we organise community health services? This is the question posed by Swerissen in his paper in the Forum section of this issue. Within the context of reforms to the health system with an increased focus on improving efficiency, he argues that the organisation of community services should be driven by the functional relations between general care, acute care and co-ordinated care. The efficiency of vertical and horizontal integration and the creation of community health networks is considered in relation to a number of issues including distributional equity. He concludes that community health networks offer the most efficient model for the delivery of community based public health and general, acute and coordinated care services. It is hoped that this paper and the arguments presented will give rise to debate within the primary health care sector.

Challenges in implementing models of coordinated care

2018 ◽  
Vol 20 (3) ◽  
pp. 365-382 ◽  
Author(s):  
Nicole K Janich ◽  
Michael S Shafer
Keyword(s):  
Health Care ◽  
Behavioral Health ◽  
Care Coordination ◽  
Health Care Policy ◽  
Coordinated Care ◽  
Model Of Care ◽  
Implementation Challenges ◽  
Care Services ◽  
Primary Care Services ◽  
Health Agencies

Summary The purpose of this study is to explore implementation challenges behavioral health agencies have faced in moving toward new models of care coordination which have been mandated by health care policy. Specifically, this study looks at six behavioral health agencies in a rural region of a southwestern state. Three agencies had adopted a colocated model of care coordination which involved partnering with a local Federally Qualified Health Center to provide primary care services at the behavioral health agency facilities. Three other agencies included in the study had adopted a fully integrated model of care coordination which involved hiring their own practitioners to provide primary care services at their facilities. Findings Results from this qualitative study identified seven areas of implementation challenges experienced by agencies including financial mechanisms, regulation, electronic health records, role clarification, information sharing, medical provider stigma, and staff training on coordinated care. Some of the most common challenges for all agencies regardless of the model being implemented were funding mechanisms, information sharing, and regulation. Application Findings from this study indicate that although health care policy has moved toward a more progressive form of health care, challenges still remain that threaten the sustainability of such care. Improvements at the policy level are needed to reform payment mechanisms and regulatory burden, in addition to making improvements at the local level to train practitioners.

scholarly journals Psychotropic Polypharmacy Among Youths With Serious Emotional and Behavioral Disorders Receiving Coordinated Care Services

2018 ◽  
Vol 69 (6) ◽  
pp. 716-722 ◽  
Author(s):  
Benjamin Wu ◽  
Eric J. Bruns ◽  
Ming-Hui Tai ◽  
Bethany R. Lee ◽  
Ramesh Raghavan ◽  
...  
Keyword(s):  
Behavioral Disorders ◽  
Emotional And Behavioral Disorders ◽  
Coordinated Care ◽  
Care Services

scholarly journals Is There Anything to Smile about? A Review of Oral Care for Individuals with Intellectual and Developmental Disabilities

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Kathleen Fisher
Keyword(s):  
Developmental Disabilities ◽  
Clinical Training ◽  
Oral Care ◽  
Oral Health Status ◽  
Intellectual And Developmental Disabilities ◽  
Coordinated Care ◽  
Clinical Experiences ◽  
Dental Services ◽  
Care Services ◽  
Low Expectations

Individuals with intellectual and developmental disabilities (I/DD) are at risk for dental disease and face substantial challenges in accessing both routine and preventive dental services. In terms of unmet needs it ranks third, following residential services and employment opportunities for this particular group of people. Poorer oral health status negatively impacts overall health and one’s quality of life. Factors contributing to this problem include significantly higher rates of dental caries, periodontal disease, poor oral hygiene, low expectations, fear of treatment, and lack of awareness among individuals and carers. Additional factors include problems accessing dental care or denial of services because of inadequate education and clinical training, inappropriate bias, or inadequate levels of compensation to providers. Strategies to improve service delivery include individualized and coordinated care services, education of individuals, carers, and providers, including both classroom and clinical experiences with special needs patients in dental programs.

scholarly journals General practice pharmacists in Australia: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258674
Author(s):  
Thilini Sudeshika ◽  
Mark Naunton ◽  
Louise S. Deeks ◽  
Jackson Thomas ◽  
Gregory M. Peterson ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Practice ◽  
Medication Management ◽  
Cochrane Library ◽  
Care Services ◽  
Funding Model ◽  
Primary Activity ◽  
General Practices ◽  
Meta Analyses ◽  
The Cochrane Library

Background The inclusion of pharmacists into general practices in Australia has expanded in recent years. This systematic review aimed to synthesise the literature of qualitative and quantitative studies, and identify the knowledge gaps, related to pharmacists working in general practice in Australia. Methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, EBSCOhost, EMBASE, and the Cochrane Library were searched from the inception of databases to January 2021. The search was focused on studies investigating general practice pharmacists in Australia. The quality of each study was appraised using the Mixed Method Appraisal Tool criteria. The narrative synthesis approach was utilised to describe data due to the heterogeneity among study designs and measures. Results Twenty-five studies were included in this review. General practice pharmacists engaged in various non-dispensing patient care services, with medication management reviews being the primary activity reported. General practice pharmacists’ characteristics and an environment with a willingness of collaboration were the notable influencing factors for successfully including pharmacists in general practices. Factors that posed a challenge to the adoption of general practice pharmacists were lack of funding and other resources, poorly defined roles, and absence of mentoring/training. Conclusion This review has summarised the characteristics, activities, benefits, barriers, and facilitators of including pharmacists in general practices in Australia. General practice pharmacists are well accepted by stakeholders, and they can engage in a range of patient-centred activities to benefit patients. There is a need for more robust research to explore the patient and economic outcomes related to clinical activities that a pharmacist can perform in general practice, as a foundation to developing an appropriate and sustainable funding model. The findings of this review will be beneficial for pharmacists, researchers, policymakers, and readers who wish to implement the role of general practice pharmacists in the future.

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