Comparing integrated care policy in Europe: Does policy matter?

Mur-Veeman, Ingrid; Raak, Arno van; Paulus, Aggie

doi:10.1016/j.healthpol.2007.07.008

Cited by 98 publications

(101 citation statements)

References 14 publications

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“…Despite convincing evidence and an every so often extensive history, there are still recognised needs to take research about integrated care into areas only superficially explored [3], such as the use of qualitative measures [4] and the effects on final outcomes, like for instance on improved health [5]. On the other hand, existing evidence and knowledge can probably become more ennobled and thereby contribute to a deeper understanding of the compound art of integrating of health care services.…”

Section: Introductionmentioning

confidence: 99%

The Art of Integrating Care: Theories Revisited

Åhgren¹

2012

TOPHJ

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Abstract:Integration of care is high on public health agendas all around the world. The development and implementation of integrative arrangements has been promoted for more or less two decades. Despite this every so often extensive history, there are recognised needs to take research into areas yet poorly explored, which include measures and outcomes of integrated care. On the other hand, existing evidence and knowledge can probably become more ennobled and thereby contribute to a deeper understanding of the compound art of integrating of health care services. Accordingly, the aim of this article is to re-evaluate and synthesise some revisited theories for the facilitation of sustainable integrated care solutions.This exploration shows it is important to have crucial prerequisites for integration in place: both functional and interactional conditions. This appears to be an organic process where the stakeholders go through gradual changes until the optimum level of integration as well as mutualistic interactions are established.It could be argued that refined knowledge could be excerpted from existing research. Then again, this strategy does not exclude actions for new research in poorly explored areas. Both approaches are important for the development of sustainable integrated care.

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Section: Introductionmentioning

confidence: 99%

The Art of Integrating Care: Theories Revisited

Åhgren¹

2012

TOPHJ

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“…All face the question of how to transform existing primary care into more integrated care systems to improve outcomes and reduce inefficiency Internationally, there is conceptual agreement but also a search for new models to advance primary care. 27 The variations in payment incentives, information systems, use of teams, and guidelines demonstrated in the survey reveal a rich basis for cross-national learning to inform and develop primary care models that use twenty-first-century technologies and skills creatively to yield better health outcomes and value. E l e v e n -C o u n t r y S u r v e y…”

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confidence: 99%

A Survey Of Primary Care Physicians In Eleven Countries, 2009: Perspectives On Care, Costs, And Experiences

et al. 2009

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This 2009 survey of primary care doctors in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States finds wide differences in practice systems, incentives, perceptions of access to care, use of health information technology (IT), and programs to improve quality. Response rates exceeded 40 percent except in four countries: Canada, France, the United Kingdom, and the United States. U.S. and Canadian physicians lag in the adoption of IT. U.S. doctors were the most likely to report that there are insurance restrictions on obtaining medication and treatment for their patients and that their patients often have difficulty with costs. We believe that opportunities exist for cross-national learning in disease management, use of teams, and performance feedback to improve primary care globally. Health Aff (Millwood). 2009;28(6):w1171-83 (published online 5 November 2009 10.1377/hlthaff .28.6.w1171)] P r i m a ry c a r e c l i n i c i an s i n m o s t c o u n t r i e s provide the foundation for health care systems and serve as the linchpin that improves access, connects care, and provides continuity for patients and families. Research shows that strong primary care is associated with good outcomes and lower costs.1-3 Aging populations, prevalence of chronic disease, and increasing ability to deliver complex care outside the hospital have prompted international efforts to redesign primary care to improve outcomes and efficiency. Consequently, primary care practices often face new requirements for accountability as well as incentives to improve. C a r e & C o s t s H E A LT H A F F A I R S~We b E x c l u s i v eTo varying degrees, health systems are investing in information technology (IT), round-the-clock access, providers working in teams, integration, and quality improvement. Reforms in delivery systems and payment policies seek to spur innovations for managing chronic conditions and supporting frail elderly or disabled people living in the community.Primary care physicians' experiences and perspectives in a period of rapid change offer a unique view from the front lines. To track developments in countries with diverse health systems, this 2009 study surveyed primary care physicians in eleven countries: Australia, Canada, France, Germany, Italy, New Zealand, the Netherlands, Norway, Sweden, the United Kingdom, and the United States. This survey, the twelfth in a series that informs a symposium of health ministers and policy experts, focused on access, chronic care management, health IT, and financial and information incentives-key areas that have been targets of reforms. Eleven-Country ContextThe countries studied represent a mix of primary care and insurance systems (Exhibit 1). The United States is distinct in its reliance on internal medicine and pediatrics for primary care and its highly decentralized referral systems. The other countries rely extensively on general or family practice (GP/FP) physicians, often augmented by use of pr...

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“…Integrated care strategies are considered as a means to improve quality (in terms of impact on health outcomes and responsiveness to patient needs) and to ensure cost efficiency and access to care [5][6][7]. The primary care sector plays an important role in establishing integrated care structures because it builds on the principles of continuous, comprehensive and coordinated care [8][9][10][11][12]. In primary care, different organizational forms of care provision can be found.…”

Section: Introductionmentioning

confidence: 99%

Identifying the Determinants for Attractiveness of Integrated Forms of Care from the Perspective of Health Care Professionals

Krczal¹

2017

JHS

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Abstract:Fostering integration between caregivers in the ambulatory sector involves transforming the institutional, organizational and technical framework but also redesigning the work performed by health care professionals. Empirical research on the implementation of integrated care highlights professional engagement and commitment as a key success factor during the change process. Although a mismatch of motives during the integration process is often reported only a few studies have explored motivational aspects of health care integration. The aim of this study is to explore motivational factors for health care professionals in order to identify the determinants of attractiveness of integrated forms of care. An online-questionnaire was developed to identify the most important motivational factors for health care professionals and to reflect their perceptions on the attractiveness of interdisciplinary forms of care. The sample includes practicing physicians (general practitioners and specialists), practicing nurses and non-physician professions (physiotherapists, midwives, speech therapists, occupational therapists). Findings suggest that health care professionals are highly motivated by intrinsic motivators. Physicians turned out to be the most reluctant group towards integrated care models. Participating in integrated forms of care would challenge working independently which represents a strong motivator. The responses of nurses suggest that they are the most favorable group. Integrated care forms would be attractive offering more possibilities for social relationships, expanding responsibilities and challenging work. Results support the importance of health workforce engagement and participation in planning health care integration.

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Comparing integrated care policy in Europe: Does policy matter?

Cited by 98 publications

References 14 publications

The Art of Integrating Care: Theories Revisited

The Art of Integrating Care: Theories Revisited

A Survey Of Primary Care Physicians In Eleven Countries, 2009: Perspectives On Care, Costs, And Experiences

Identifying the Determinants for Attractiveness of Integrated Forms of Care from the Perspective of Health Care Professionals

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