Comparing International Models of Integrated Care: How Can We Learn Across Borders?

Gray, Carolyn Steele; Zonneveld, Nick; Bréton, Mylaine; Wankah, Paul; Shaw, James C.; Anderson, Geoff; Wodchis, Walter P.

doi:10.5334/ijic.5413

Cited by 12 publications

(14 citation statements)

References 24 publications

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“…Steps should be taken to address these issues and needs. Other work in this area has recommended creating more institutional structures that facilitate patient engagement, such as covering transportation costs for patients, covering childcare or caregiver support, remunerating patients for the time taken off work, interpreter fees and covering other costs associated with engagement 25 . Creating supports such as these may break down some of the barriers, which may be currently preventing those from underrepresented demographic groups from participating in the policy process.…”

Section: Discussionmentioning

confidence: 99%

“…Policymakers should encourage diversity in the recruitment of patients and facilitate the inclusion of a variety of perspectives to ensure decisions in the PHC system can be inclusive of all patients in the population. The discussion surrounding the lack of diverse patient representation in engagement opportunities has been noted by other scholars as an area requiring improvement 4,25,26 . While it is promising to see that patients, family members and caregivers are being engaged, it is crucial for the PHC system to increase the number of patient partner positions and recruit individuals from diverse demographic groups moving forward.…”

Section: Discussionmentioning

confidence: 99%

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Patient, family member and caregiver engagement in shaping policy for primary health care teams in three Canadian Provinces

Hirschkorn

Rai

Parniak

et al. 2022

Health Expectations

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Introduction: Improving health services integration through primary health care (PHC) teams for patients with chronic conditions is essential to address their complex health needs and facilitate better health outcomes. The objective of this study was to explore if and how patients, family members, and caregivers were engaged or wanted to be engaged in developing, implementing and evaluating health policies related to PHC teams. This patient-oriented research was carried out in three provinces across Canada: British Columbia, Alberta and Ontario.Methods: A total of 29 semi-structured interviews with patients were conducted across the three provinces and data were analysed using thematic analysis.Results: Three key themes were identified: motivation for policy engagement, experiences with policy engagement and barriers to engagement in policy. The majority of participants in the study wanted to be engaged in policy processes and advocate for integrated care through PHC teams. Barriers to patient engagement in policy, such as lack of opportunities for engagement, power imbalances, tokenism, lack of accessibility of engagement opportunities and experiences of racism and discrimination were also identified. Conclusion:This study increases the understanding of patient, family member, and caregiver engagement in policy related to PHC team integration and the barriers that currently exist in this engagement process. This information can be used to guide decision-makers on how to improve the delivery of integrated health services

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patient, family member and caregiver engagement in shaping policy for primary health care teams in three Canadian Provinces

Hirschkorn

Rai

Parniak

et al. 2022

Health Expectations

View full text Add to dashboard Cite

show abstract

“…An important theme highlighted in the policy documents that supports integrated health services is access to interoperable EHRs accessible to all IPHC team members. This is especially crucial for teams that are not co-located and more so in the current context of virtual care being delivered by virtual teams, to facilitate continuity of care and seamless provider communication [ 61 ]. In fact, patients may view this as a key measure of the health system’s performance [ 62 ].…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

“…In this review, QC was the province to focus most on creating a provincially compatible EHR for lab results, although strides have been made more recently in AB to innovate health information systems. Information systems are mentioned frequently in IPHC policy documents, yet many recommendations, as noted by Steele Gray et al [ 61 ], made in policies have not yet been realized. Continued work in this area is needed for both improved integration of team-based services and streamlined communication between providers and providers and patients.…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

Facilitating Integration Through Team-Based Primary Healthcare: A Cross-Case Policy Analysis of Four Canadian Provinces

et al. 2021

Self Cite

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“…The theory and practice of organizational design for an IDS have been thoroughly demonstrated around the world over the last decade [13][14][15][16][17]. There is plenty of evidence and guidance for policymakers on how to design and implement an IDS.…”

Section: Discussionmentioning

confidence: 99%

Implementation and Early Impacts of an Integrated Care Pilot Program in China: Case Study of County-level Integrated Health Organizations in Zhejiang Province

Meng

Wang

et al. 2021

International Journal of Integrated Care

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Background: One of the most noticeable integrated care-related policies in China is the growth and proliferation of County-level Integrated Health Organizations (CIHOs), which take over a set of primary healthcare institutions to form an integrated delivery network in order to achieve an ordered hierarchical delivery system by strengthening primary care.Objectives: This paper presents emerging findings from an ongoing evaluation of the early impacts of the demonstrator site, Deqing CIHO, in Zhejiang Province, in order to examine the extent to which the implementation has achieved its core objectives: (1) establishing the hierarchical referral system, (2) capacity building of primary healthcare providers, and (3) reducing the costs.Design: This case study was conducted to determine institutional and managerial processes.Settings: Data were collected and analyzed at the CIHO and county level. A structured questionnaire was used for data collection.Primary and secondary outcome measures: Indicators were selected from the existing database of the county health system and arranged into three segments to assess (1) service utilization among each level of care; (2) capacity-building progress for primary care centers, (3) cost-related indicators for both levels of care.Results: Service utilization data show that one year after CIHO implementation, the proportion of patients who chose to get inpatient care outside of the county decreased from 27.3% to 24.5%. Hospital admissions were retrieved from outside the county, while service volume slightly shifted from hospitals to primary care sites. Capacitybuilding indicators for township health centers show that 6 out of 12 items showed better performance compared to the national average growth rate, and a moderated growth rate appeared in terms of per capita cost. Conclusion:Progress evaluation results from Deqing CIHO indicated some positive effects on three main outcomes, which reveal the potential of CIHOs in not only strengthening primary care but also controlling cost as a result of early implementation. Further emphases of evaluation are required to determine the impacts on the quality and experience of care that are estimated using claim-based data at the individual level.

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Comparing International Models of Integrated Care: How Can We Learn Across Borders?

Cited by 12 publications

References 24 publications

Patient, family member and caregiver engagement in shaping policy for primary health care teams in three Canadian Provinces

Patient, family member and caregiver engagement in shaping policy for primary health care teams in three Canadian Provinces

Facilitating Integration Through Team-Based Primary Healthcare: A Cross-Case Policy Analysis of Four Canadian Provinces

Implementation and Early Impacts of an Integrated Care Pilot Program in China: Case Study of County-level Integrated Health Organizations in Zhejiang Province

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