Evaluation of the integrated clinic model for HIV/AIDS services in Ho Chi Minh City, Viet Nam, 2013–2014

Integration of care for HIV and opioid use disorder

“…We identified six studies that occurred in HIV care settings [12, 17-20, 57, 58, 61-63, 67, 73], 12 studies that occurred in opioid treatment settings [52-56, 60, 64-66, 68-70, 74, 75], and five studies that occurred in other settings, including correctional settings [71,72], primary care clinics [58], mobile syringe-exchange units [15] or public health clinics [59]. The added element that defined interventions as integrated care was most often either OUD care or HIV care alone to a facility already providing care for the other disorder; in two studies both OUD and HIV care were introduced simultaneously and correctional facilities were the points-of-entry for both [71,72].…”

“…While most studies took place in North America (n=15 in the United States and n=1 in Canada), four took place in Europe [53,54,60,68] and three took place in Asia [52,59,74]. Half of studies had a follow-up period of 12 months or longer ( Table 1).…”

“…Other interventions (n=5) occurred in primary care clinics [58], mobile syringe-exchange units [15], government-run public health clinics [59], or used the criminal justice system as a point-of-entry [71,72]. An intervention in primary care settings demonstrated that those receiving buprenorphine/naloxone, when randomized to brief sexual risk management or enhanced sexual risk management, exhibited similar process (retention in OUD treatment) and clinical outcomes (health-related quality of life or sexual risk) [58].…”

Integrated care: learning between high-income, and low- and middle-income country health systems

“…in England, health is free while social care is means tested) Financial incentives not aligned across types of providers (e.g. acute, primary health care) Competing for resources preventing collaboration (competition rules) Workforce with high degree of professional specialization Lack of IT inter-operability and restrictive information governance rules Lack of ‘hump’ funds to allow providers to transition to different models of care Health care and social care separated by language, conceptions of health, professional cultures and ways of working Primary and community health care sector under-resourced Siloed funding and reporting, with donors wanting accountable results for their specific programmes Lack of incentives for well-funded programmes to integrate with poorer ones Lack of negotiating power for under-funded programmes Limited capacity, support for and number of staff Poor and fragmented Health Management Information Systems (HMIS) infrastructure Fragmented, poorly coordinated care across agencies/sectors Primary health care is generally under-resourced Sources: Armitage et al (2009) , Erens et al (2016) , Leggat and Leatt (1997) , Mangiaterra (2014) , Maruthappu et al (2015) , van der Klauw et al (2014) , Curry and Ham (2010) , Ham et al (2011) , Watt et al (2016) , King’s Fund (2014) and Hung et al (2016) . …”

“… Sources: Armitage et al (2009) , Erens et al (2016) , Leggat and Leatt (1997) , Mangiaterra (2014) , Maruthappu et al (2015) , van der Klauw et al (2014) , Curry and Ham (2010) , Ham et al (2011) , Watt et al (2016) , King’s Fund (2014) and Hung et al (2016) . …”