Building a model of integrated care (ic) in home care (hc)

Contel, Juan Carlos; Rusines, Dolors; Hilarión, Pilar; Santaeugènia, Sebastià; Ferran, Eva; Agud, Laura

doi:10.5334/ijic.s3104

Int J Integr Care

2019

DOI: 10.5334/ijic.s3104

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Building a model of integrated care (ic) in home care (hc)

Juan Carlos Contel¹,

Dolors Rusines

Pilar Hilarión³

et al.

Abstract: Building a model of integrated care (ic) in home care (hc)

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“…Older persons are reported to experience loneliness, which seem increase with several long-term conditions [4]. Hence, to support older patients' and their next of kin's needs to self-care, live well in their situation and participation in health care, despite health problems, different integrated care models have been implemented and researched in several places around the world [5][6][7][8][9][10][11][12]. Integrated care models bring together several professions in different constellations.…”

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confidence: 99%

“…They might include municipality nurses working in collaboration with a patient's family physician [12,14] or with a patient's primary care center physician [15]. Integrated care models have also been described as territory-based, where each geographic area develops its own version [6]. An integrated care approach can lead to a reduction in unnecessary hospitalization [16], faster response time to patient needs, better informed assessments, and pro-active identification of patient issues [14].…”

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The role of the home health care physician in mobile integrated care: a qualitative phenomenograpic study

et al. 2022

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Background An increasing older population, along with the organizational principle of remaining at home, has moved health care from institutions into the older person’s home, where several health care providers facilitate care. The Mobile Integrated Care Model strives to provide cost-efficient, coherent, person-centered health care in the home. In the integrated care team, where the home health care physician is the medical authority, several health care professions work across organizational borders. Therefore, the aim of this study was to describe Home Health Care Physicians perceptions of working and providing health care in the Mobile Integrated Care Model, as well as perceptions of participating in and forming health care. Methods A phenomenographic qualitative study design, with semi-structured interviews using an interview guide. Results Working within Mobile Integrated Care Model was a different way of working as a physician. The physicians’ role was to support the patient by making safe medical decisions. Physicians described themselves as a piece in the team puzzle, where the professional knowledge of others was crucial to give quality health care. Being in the patients’ homes was expressed as adding a unique dimension in the provision of health care, and the physicians learned more about the patients by meeting them in their homes than at an institution. This aided the physicians in respecting patient autonomy in medical decision making, even though the physicians sometimes disregarded patient autonomy in favor of their own medical experience. There was a divided view on next of kin participation among the home health care physicians, ranging from always including to total absence of involving next of kin in decision making. Conclusions The home health care physicians described the Mobile Integrated Care Model as the best way to work, but there was still a need for additional resources and structure when working in different organizations. The need for full-time employment, additional time or hours, more equipment, access to each other’s medical records, and additional collaboration with other health care providers were expressed, which could contribute to increased work satisfaction and facilitate further development of person-centered care in the Mobile Integrated Care Model.

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confidence: 99%

The role of the home health care physician in mobile integrated care: a qualitative phenomenograpic study

et al. 2022

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Patients’ and next of kin’s expectations and experiences of a mobile integrated care model with a home health care physician – a qualitative thematic study

Emmesjö,

Gillsjö,

Dahl Aslan

et al. 2023

BMC Health Serv Res

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Background The organizational principle of remaining at home has offset care from the hospital to the home of the older person where care from formal and informal caregivers is needed. Globally, formal care is often organized to handle singular and sporadic health problems, leading to the need for several health care providers. The need for an integrated care model was therefore recognized by health care authorities in one county in Sweden, who created a cross-organisational integrated care model to meet these challenges. The Mobile integrated care model with a home health care physician (MICM) is a collaboration between regional and municipal health care. Descriptions of patients’ and next of kin’s experiences of integrated care is however lacking, motivating exploration. Method A qualitative thematic study. Data collection was done before the patients met the MICM physician, and again six months later. Results The participants expected a sense of relief when admitted to MICM, and hoped for shared responsibility, building a personal contact and continuity but experienced lack of information about what MICM was. At the follow-up interview, participants described having an easier daily life. The increased access to the health care personnel (HCP) allowed participants to let go of responsibility, and created a sense of safety through the personalised contact and continuity. However, some felt ignored and that the personnel teamed up against the patient. The MICM structure was experienced as hierarchical, which influenced the possibility to participate. However, the home visits opened up the possibility for shared decision making. Conclusion Participants had an expectation of receiving safe and coherent health care, to share responsibility, personal contact and continuity. After six months, the participants expressed that MICM had provided an easier daily life. The direct access to HCP reduced their responsibility and they had created a personalised contact with the HCP and that the individual HCP mattered to them, which could be perceived as in line with the goals in the shift to local health care. The MICM was experienced as a hierarchic structure with impact on participation, indicating that all dimensions of person-centred care were not fulfilled.

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Building a model of integrated care (ic) in home care (hc)

Abstract: Building a model of integrated care (ic) in home care (hc)

Cited by 2 publications

References 0 publications

The role of the home health care physician in mobile integrated care: a qualitative phenomenograpic study

The role of the home health care physician in mobile integrated care: a qualitative phenomenograpic study

Patients’ and next of kin’s expectations and experiences of a mobile integrated care model with a home health care physician – a qualitative thematic study

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