How do integrated care initiatives impact on consumer experience? Petra Bywood, Lynsey Brown & Jodie Oliver-Baxter European Forum for Primary Care, 9-10.

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Presentation transcript:

How do integrated care initiatives impact on consumer experience? Petra Bywood, Lynsey Brown & Jodie Oliver-Baxter European Forum for Primary Care, 9-10 September 2013, Istanbul

Fragmented care Services are hard to find GPs unaware of patients’ hospital visits Vulnerable populations miss out on services Conflicting advice for multimorbidity Lack of coordination across sectors    Duplications / Gaps / Adverse Events Patients want accessible, affordable, coordinated, integrated local health services

Method Literature review Electronic databases, grey literature, websites, organisation publications Search Terms Integration, integrated care (synonyms) Literature Publicly available, last 5 years Peer-reviewed articles, program papers, reports, government documents

What do patients value most? Continuity of care, specific personnel, care teams After-hours access to care & advice Sensitivity to needs (cultural) Involvement in medical decision-making Links between health and social services Co-location of services (multidisciplinary)

Key mechanisms of integration Shared vision Shared culture Funding models Structural arrangements Effective communication & support Collaborative practice Governance structures Tailored service delivery Common care processes Information-sharing platforms

Australian examples of integrated care Australian Comprehensive PHC (Jackson et al. 2010) Indigenous attendance increased Increased glycaemic control GP Super Clinics (Consan Consulting 2012) 83% patients attended because of access to wide range of providers 66% patients reported staff coordinated all aspects of their care Referrals, access, communication improved Jackson et al. (2010) GPs with special interests impacting on complex diabetes care. AFP vol. 39 Consan Consulting (2012) Evaluation of the GP Super Clinics program Canberra: Dept of Health and Ageing

Challenges Limitations of the research Lack of consensus/consistency Inadequate time for follow-up Barriers to integration Lack of clarity in roles, responsibilities Lack of engagement with other sectors Lack of sustained funding for integration Time-consuming processes

Take-away messages It’s complicated! Better integration for patients means: At local (micro) level: more attention to change processes, communication modalities and care pathways At organisational (meso) level: tailored support for care providers, engagement across health and social care At systems (macro) level: policies that enable organisations & providers to deliver integrated care