Care management for older people: Does integration make a difference?

Challis, David; Stewart, Karen; Donnelly, Michael; Weiner, Kate; Hughes, Jane

doi:10.1080/13561820600727130

Cited by 30 publications

(23 citation statements)

References 12 publications

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“…2,3 Although most care organizations want to innovate and improve quality of care, many lack expertise or financial re sources needed to do so. 4,5 Family physicians are responsible for medical care in residential care facilities in the Netherlands. However, they do not regard themselves as suited for systematic management of chronic diseases and disabilities associated with frail health.…”

mentioning

confidence: 99%

Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial

Boorsma¹,

Frijters²,

Knol³

et al. 2011

Canadian Medical Association Journal

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mentioning

confidence: 99%

Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial

Boorsma¹,

Frijters²,

Knol³

et al. 2011

Canadian Medical Association Journal

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“…Our findings suggest that, in terms of the central objective to care for older people outside of institutional settings, the picture in Northern Ireland is more muted than that in England. Delayed discharges from hospital of patients needing care by social services has also been signaled as a problem in Northern Ireland and this is despite closer links between health and social services (Challis et al, 2006b). There may be lessons from other sectors here.…”

Section: Discussionmentioning

confidence: 99%

Has social care performance in England improved? An analysis of performance ratings across social services organisations

et al. 2009

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Performance measurement in the English public sector has been implemented in a top-down manner. The mechanics of this regime (centralised targets, public reporting of performance data and the use of rewards and penalties) are driven by central government and are intended to hold agencies to account for their performance and regulate their behaviour. This paper examines whether the operation of such a regime has resulted in the improved performance of social care organisations. Comparable data from Northern Ireland Health and Social Services Trusts, where performance measurement processes are less centrally driven and rewards and penalties are less contingent on ratings, are used to investigate the potential impact of different performance regimes. Indicators of admissions to residential care and delayed discharges from hospital are used to signal progress in the meeting of social care objectives in the two countries.We find that in England social care organisations have broadly improved their performance over time in composite ('star') ratings and with generally higher ratings across individual indicators, with noteworthy improvement across key threshold indicators (measures which councils must perform well on to obtain a good summary rating). The comparative analysis highlights the differences across the two countries with an improvement in performance over time in England and a fairly static picture in Northern Ireland. These improvements may reflect a host of factors other than the incentives created by centralised targets and measures. Our data show, for example, that external characteristics of English councils predominantly influence their being reported as 'poor performers'.Evidence suggests that the rate of performance improvement reflects the incentives inherent in the English performance system. An incentive structure that promotes the 3 achievement of specific targets may have influenced the behaviour of local managers responsible for performance in this sector. However, further information from local organisations is required to more fully explicate all the relevant factors that may have a bearing on reported performance. The evidence reported here does, however, point to the beneficial effects (at least for the regulator) of centrally set measures. It is uncertain whether more recent moves away from this target regime in England, towards the development of local indicators and 'individual incentive' regulation, will likewise offer the appropriate inducements for performance improvement.

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“…Social care in Northern Ireland has, in the content of practice, largely followed the lines of that in England, for example the key professionals assessing and planning care locally are, similarly, care managers (Challis et al, 2006b). However, the form of organization is different.…”

Section: Northern Irelandmentioning

confidence: 99%

“…These evaluations, however, have been either small-scale exploratory studies of the views of stakeholders (Heenan and Burrell, 2006) or studies investigating patterns of team working (Reilly et al, 2003;Challis et al, 2006b). Evaluations at the organizational level using performance data to gauge the effects of system differences are limited, the review by Appleby (2005) being one recent exception.…”

Section: Notesmentioning

confidence: 99%

Comparing How to Compare: An Evaluation of Alternative Performance Measurement Systems in the Field of Social Care

et al. 2010

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Comparative performance evaluation has taken different forms depending upon the purposes of performance monitoring and the types of measures available. This paper investigates the different performance measurement systems in place in the social care setting, in particular for older people receiving community care services. In England, earlier systems to assist performance management within organizations have been eclipsed by national systems of regulation with topdown implementation of standards and measures. In Northern Ireland, by contrast, organizations have been compared descriptively without the use of national targets. Internationally, in Japan, organizations arranging similar services have had more local information available collected in a bottom-up fashion with greater employment of service user-level data. These differences in performance evaluation are located within an analytical framework permitting comparisons of system design and the use of measures. Conclusions are drawn concerning the breadth of evidence available for successfully monitoring service provision in this setting.

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Care management for older people: Does integration make a difference?

Cited by 30 publications

References 12 publications

Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial

Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial

Has social care performance in England improved? An analysis of performance ratings across social services organisations

Comparing How to Compare: An Evaluation of Alternative Performance Measurement Systems in the Field of Social Care

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