Assessment of a primary and tertiary care integrated management model for chronic obstructive pulmonary disease

Bolíbar, Ignasi; Plaza, Vicente; Llauger, M.; Amado, Ester; Antón, Pedro A; Espinosa, Ana; Domínguez, Leandra; Fraga, Mar; Freixas, Montserrat; Fuente, J. A. De la; Liguerre, Iskra; Medrano, Casimira; Peiró, Meritxell; Pou, Mariantònia; Sanchís, J.; Solanes, Ingrid; Valero, Carles; Valverde, Pepi

doi:10.1186/1471-2458-9-68

Cited by 11 publications

(8 citation statements)

References 40 publications

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“…Other models describe care pathways that aim to ensure adequate follow-up after discharge, involving both specialist and primary care services [14,15]. Most studies in the field evaluate models that have been initiated by specialist care services and are based on treatment of single diseases like stroke, heart failure and COPD [16-18]. Some studies describe care pathways for hospitalized elders more generally [19].…”

Section: Introductionmentioning

confidence: 99%

Development of a patient-centred care pathway across healthcare providers: a qualitative study

Røsstad

Garåsen

Steinsbekk

et al. 2013

BMC Health Serv Res

119

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BackgroundDifferent models for care pathways involving both specialist and primary care have been developed to ensure adequate follow-up after discharge. These care pathways have mainly been developed and run by specialist care and have been disease-based. In this study, primary care providers took the initiative to develop a model for integrated care pathways across care levels for older patients in need of home care services after discharge. Initially, the objective was to develop pathways for patients diagnosed with heart failure, COPD and stroke. The aim of this paper is to investigate the process and the experiences of the participants in this developmental work. The participants were drawn from three hospitals, six municipalities and patient organizations in Central Norway.MethodsThis qualitative study used focus group interviews, written material and observations. Representatives from the hospitals, municipalities and patient organizations taking part in the development process were chosen as informants.ResultsThe development process was very challenging because of the differing perspectives on care and different organizational structures in specialist care and primary care. In this study, the disease perspective, being dominant in specialist care, was not found to be suitable for use in primary health care because of the need to cover a broader perspective including the patient’s functioning, social situation and his or her preferences. Furthermore, managing several different disease-based care pathways was found to be unsuitable in home care services, as well as unsuitable for a population characterized by a substantial degree of comorbidity. The outcome of the development process was a consensus that outlined a single, common patient-centred care pathway for transition from hospital to follow-up in primary care. The pathway was suitable for most common diseases and included functional and social aspects as well as disease follow-up, thus merging the differing perspectives. The disease-based care pathways were kept for use within the hospitals.ConclusionsDisease-based care pathways for older patients were found to be neither feasible nor sustainable in primary care. A common patient-centred care pathway that could meet the needs of multi- morbid patients was recommended.

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Section: Introductionmentioning

confidence: 99%

Development of a patient-centred care pathway across healthcare providers: a qualitative study

Røsstad

Garåsen

Steinsbekk

et al. 2013

BMC Health Serv Res

119

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“…Se realizó una evaluación basal (febrero-octubre 2008) y una evaluación final (septiembre-diciembre de 2010) al cabo de una media de 31,2 meses. Los detalles del estudio se han descrito en una publicación previa 17 .…”

Section: Materials Y Métodosunclassified

¿Es útil la implantación de programas de gestión clínica de los pacientes con enfermedad pulmonar obstructiva crónica? Comparación de la efectividad de dos intervenciones sobre la evolución clínica y la atención recibida

et al. 2018

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“…Se trata de un estudio descriptivo de una muestra aleatoria procedente de una població n de pacientes con EPOC de 2 á reas sanitarias de Barcelona entre octubre de 2007 y octubre de 2008 16 .…”

Section: Pacientes Y Mé Todounclassified

Características de la enfermedad pulmonar obstructiva crónica en fase estable relacionadas con la inflamación sistémica

et al. 2012

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Assessment of a primary and tertiary care integrated management model for chronic obstructive pulmonary disease

Cited by 11 publications

References 40 publications

Development of a patient-centred care pathway across healthcare providers: a qualitative study

Development of a patient-centred care pathway across healthcare providers: a qualitative study

¿Es útil la implantación de programas de gestión clínica de los pacientes con enfermedad pulmonar obstructiva crónica? Comparación de la efectividad de dos intervenciones sobre la evolución clínica y la atención recibida

Características de la enfermedad pulmonar obstructiva crónica en fase estable relacionadas con la inflamación sistémica

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