1. Integrated Care What do we stand to gain? Kim Sutherland, PhD Director, System and Thematic Reports 22 November 2014

2. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.2 In brief What is integrated care? What do we stand to gain? What do we know? – Perspectives – Measurement

3. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.3 3 Primary, secondary, tertiary and quarternary care Patient-centred Partnerships Collaboration Responsiveness Continuity Coordination Seamless Mental and physical health Multidisciplinary Tailored Linking Within, across, between teams Right care, right place, right time Hospitals and communities

4. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.4 NSW Health Integrated Care Strategy 2014-2017 Integrated care involves the provision of seamless, effective and efficient care that responds to all of a person’s health needs, across physical and mental health, in partnership with the individual, their carers and family.

5. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.5 Benefits of integrated care Better patient experiences Improved outcomes Improved adherence to treatment Improved quality of life Improved efficiency

6. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.6 Poorly integrated care associated with: Duplication of services and infrastructure Under- and over-use of resources Medical errors and adverse events Accessibility problems Discontinuity in care Unmet healthcare needs

7. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.7 Perspectives of integrated care System Organisations Teams Patients

8. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.8 Measuring integrated care Effects of integrated care are wide-ranging – Accessibility – Appropriateness – Effectiveness – Efficiency – Equity – Sustainability Timescales vary Outcomes, processes, structures

9. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.9 Why ask the patient? Patients as witnesses of, and as participants in, integration Patients are sometimes the only connection between providers / sectors / specialties Baseline for measuring change over time Patients’ experiences relate to many, but not all, aspects of integrated care

10. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.10 International framework for measuring integrated care Coordinated within care team Coordinated across care teams Coordinated between care teams and community resources Continuous familiarity with patient over time Continuous proactive and responsive action between visits Patient-centred Shared responsibility (Singer et al, Medical Care Research and Review, 2011)

11. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.11 Questions or comments?

12. Bureau of Health Information Trusted information. Informed decisions. Improved healthcare.12 Equity: health for all, healthcare that’s fair Resources, structures and organisation Healthcare services Productivity Patient needs and expectations Impact Patient outcomes Sustainability: caring for the future Economic context Social context Political context Technological context Our framework to measure performance