"We Are All in This Together": Integrated Health Service Plans in Ontario

Eliasoph, Hy; Monaghan, Barry; Beaudoin, Rémy; Cushman, R. A.; DuBois-Wing, Gwen; Emery, Marilyn J.; Fenn, W. Michael; Hanmer, Sandra J.; Huras, Paul; Lowi-Young, Mimi; Mandy, Pat; Trimnell, Jean; Switzer, Garry; Woolgar, Tony; Butler, John R.

doi:10.12927/hcq.2007.18938

Cited by 8 publications

(15 citation statements)

References 2 publications

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“…The design of studies defined as descriptive case studies was often reported simply as ‘qualitative’, although one reported details on the method used to analyse the qualitative data . One case study in Italy was reported as employing ‘quantitative’ methods, while another provided no information about their case study design or methodology .…”

Section: Resultsmentioning

confidence: 99%

“…Where the public was defined and/or operationalized, definitions included some of the following: representatives of patient organizations; ordinary citizens, further operationalized as ‘individuals with no particular axe to grind and whose voices might not otherwise be heard’; individuals who lived in [area]; citizen members of a community/local residents; and community . Similarly, definitions and operationalization of ‘public involvement’ varied among studies.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

What is the evidence base for public involvement in health‐care policy?: results of a systematic scoping review

Conklin

Morris

Nolte

2012

Health Expectations

145

149

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

What is the evidence base for public involvement in health‐care policy?: results of a systematic scoping review

Conklin

Morris

Nolte

2012

Health Expectations

145

149

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show abstract

“…Traditional, siloed, organ-based care approaches have failed to provide the holistic, accessible, 'linked-up' care now requiredparticularly for the growing numbers of community-dwelling frail elderly (Boyd et al 2005). Canada, the United Kingdom and New Zealand have introduced legislative or policy initiatives to advance integration of primary and secondary care (Eliasoph et al 2007;Ministry of Health 2011;Goodwin et al 2012). In Australia, both the National Health and Hospital Reform Commission report (Australian Government National Health and Hospitals Reform Commission 2009) and the National Primary Care Strategy (Australian Government Department of Health and Ageing 2009) have strongly endorsed the need to redesign the health system towards accessible integrated services, particularly for people with chronic disease.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of integrated models of health care delivered at the primary–secondary interface: how effective is it and what determines effectiveness?

Mitchell

Burridge

Zhang

et al. 2015

Aust. J. Prim. Health

116

144

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Abstract.Integrated multidisciplinary care is difficult to achieve between specialist clinical services and primary care practitioners, but should improve outcomes for patients with chronic and/or complex chronic physical diseases. This systematic review identifies outcomes of different models that integrate specialist and primary care practitioners, and characteristics of models that delivered favourable clinical outcomes. For quality appraisal, the Cochrane Risk of Bias tool was used. Data are presented as a narrative synthesis due to marked heterogeneity in study outcomes. Ten studies were included. Publication bias cannot be ruled out. Despite few improvements in clinical outcomes, significant improvements were reported in process outcomes regarding disease control and service delivery. No study reported negative effects compared with usual care. Economic outcomes showed modest increases in costs of integrated primary-secondary care. Six elements were identified that were common to these models of integrated primary-secondary care: (1) interdisciplinary teamwork; (2) communication/information exchange; (3) shared care guidelines or pathways; (4) training and education; (5) access and acceptability for patients; and (6) a viable funding model. Compared with usual care, integrated primary-secondary care can improve elements of disease control and service delivery at a modestly increased cost, although the impact on clinical outcomes is limited. Future trials of integrated care should incorporate design elements likely to maximise effectiveness.

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“…16 Internationally, there have been several initiatives to facilitate the development of healthcare delivery systems that meet the needs of the population they serve rather than operate purely on a service model. [17][18][19][20][21] Examples are the formation of Accountable Healthcare Organisations (ACOs) in the US, in which groups of providers take responsibility for improving the overall health status, efficiency of healthcare delivery and healthcare experience for a defined population, 22,23 and the Clinical Commissioning Groups (CCGs) in England, which are clinically led statutory National Health Service (NHS) bodies responsible for the planning and commissioning of healthcare services that meet the documented needs of their local area (NHS England). 24 Central to these developments is the need for reliable data sources, both quantitative and qualitative, that provide service planners with the information required to make decisions about which services to commission.…”

Section: Introductionmentioning

confidence: 99%

Scoping of models to support population-based regional health planning and management: comparison with the regional operating model in Victoria, Australia

Lévesque

O'Dowd

Shé

et al. 2017

Aust. Health Review

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Objective The aim of the present study was to try to understand the breadth and comprehensiveness of a regional operating model (ROM) developed within the Victorian Department of Health's North West Metropolitan Region office in Melbourne, Australia.Methods A published literature search was conducted, with additional website scanning, snowballing technique and expert consultation, to identify existing operating models. An analytical grid was developed covering 16 components to evaluate the models and assess the exhaustiveness of the ROM.Results From the 34 documents scoped, 10 models were identified to act as a direct comparator to the ROM. These concerned models from Australia (n = 5) and other comparable countries (Canada, UK). The ROM was among the most exhaustive models, covering 13 of 16 components. It was one of the few models that included intersectoral actions and levers of influence. However, some models identified more precisely the planning tools, prioritisation criteria and steps, and the allocation mechanisms.Conclusions The review finds that the ROM appears to provide a wide coverage of aspects of planning and integrates into a single model some of the distinctive elements of the other models scoped.What is known about the topic? Various jurisdictions are moving towards a population-based approach to manage public services with regard to the provision of individual medical and social care. Various models have been proposed to guide the planning of services from a population health perspective. What does this paper add? This paper assesses the coverage of attributes of operating models supporting a population health planning approach to the management of services at the regional or local level. It provides a scoping of current models proposed to organise activities to ensure an integrated approach to the provision of services and compares the scoped models to a model recently implemented in Victoria, Australia. What are the implications for practitioners? This paper highlights the relative paucity of operating models describing in concrete terms how to manage medical and social services from a population perspective and encourages organisations HEALTH SERVICE RESEARCH that are accountable for securing population health to clearly articulate their own operating model. It outlines strengths and potential gaps in current models.Additional keywords: population health approach.

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"We Are All in This Together": Integrated Health Service Plans in Ontario

Cited by 8 publications

References 2 publications

What is the evidence base for public involvement in health‐care policy?: results of a systematic scoping review

What is the evidence base for public involvement in health‐care policy?: results of a systematic scoping review

Systematic review of integrated models of health care delivered at the primary–secondary interface: how effective is it and what determines effectiveness?

Scoping of models to support population-based regional health planning and management: comparison with the regional operating model in Victoria, Australia

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