Integrated care as a priority of the Basque Strategy for Chronic Diseases: the Bidasoa Integrated Healthcare Organisation

Polanco, Núria Toro; Arce, Regina Sauto; Solinís, Roberto Nuño; Zabalegui, Iñaki Berraondo; Irazusta, Itziar Pérez

doi:10.5334/ijic.792

Cited by 2 publications

(4 citation statements)

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“…The positive results can be found in the different providers (all organisations are part of Osakidetza), but those who implemented The Strategy earlier, were more adherent to the orthodoxy of the CCM, or adopted an OSI-like model showed the best results. 8 Progress within the CCM was measured with the tool IEMAC-ARCHO. 12…”

Section: Discussionmentioning

confidence: 99%

“…In meeting this challenge, The Strategy chose to build on the strengths of the existing model of primary care to manage chronic conditions. The desired goal was to strike a new and better balance between levels Sources: Adapted from Nuño-Solin ıs, 4 Toro Polanco et al, 7,8 Mira et al, 27 and Cordero et al 28 CCM: Chronic Care Model. Bottom-up innovations were promoted and pursued, mainly through action research projects, and thus variations and local particularities were welcomed in areas such as new nursing profiles, patient empowerment, health and social care coordination and clinical integration and collaborative care.…”

Section: Context-mechanisms-outcomes Interplaymentioning

confidence: 99%

“…The Strategy has been described and analysed in various publications, and preliminary evaluations of results have already been published. [4][5][6][7][8] However, there is a lack of understanding of the social mechanisms by which this large-system transformation effort has achieved its impacts in this particular context.…”

Section: Introductionmentioning

confidence: 99%

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A system-wide transformation towards integrated care in the Basque Country: A realist evaluation

Urtaran-Laresgoiti

Alvarez‐Rosete²,

Nuño-Solinís

2018

International Journal of Care Coordination

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Introduction: In 2010, in a context of severe economic recession, the Basque Government launched the Strategy to tackle the challenge of chronicity in the Basque Country to transform the Basque health system to cope with the challenges of chronicity, ageing, health system fragmentation and sustainability in the long run. Methods: A realist evaluation has been conducted, and through a combination of research methods, information has been analysed to identify context, mechanisms and outcomes. The research provides a snapshot of the experience of a system-wide, complex health system transformation, which aims to identify 'what has worked, for whom and under what circumstances'. Twenty-two semi-structured interviews held between June 2015 and December 2016, allowed us to obtain both retrospective and real-time accounts on the transformation phenomenon. Results: Research pointed out that system-wide transformation requires time, effort, leadership, vision and narrative, as well as commitment, inclusiveness, collaborative decision-making processes with local implementers, 'muddling through' and constant learning. Key levers to shake and shift the health and social care systems towards closer alignment, coordination and integration to meet the needs of people include promoting collaborative relationships between health professionals to ensure care continuity, developing new staff roles, investing in integrated electronic health records, stratifying the population by risk and facilitating bottom-up innovation. Discussion: Research has shown that system-wide changes in health and social care have been viable in the Basque Health System, although the interplay between context, mechanisms and outcomes is more complex than expected, leading to many unexpected factors, patterns and relationships.

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Section: Discussionmentioning

confidence: 99%

Section: Context-mechanisms-outcomes Interplaymentioning

confidence: 99%

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A system-wide transformation towards integrated care in the Basque Country: A realist evaluation

Urtaran-Laresgoiti

Alvarez‐Rosete²,

Nuño-Solinís

2018

International Journal of Care Coordination

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“…It would be nonsense to expect that Greece could grasp – in terms of integrated care – these countries within 5 or 10 years. Greece could follow the recent attempts in Spain to reform health care system towards integrated care after following successful pilots in the Basque and Catalonia regions [ 89 , 90 ]. Therefore, a stepwise approach to care integration is recommended.…”

Section: Action Plan Towards Integration Of Carementioning

confidence: 99%

Bridging knowledge to develop an action plan for integrated care for chronic diseases in Greece

Tsiachristas¹,

Lionis²,

Yfantopoulos

2015

Int J Integr Care

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The health, social and economic impact of chronic diseases is well documented in Europe. However, chronic diseases threaten relatively more the ‘memorandum and peripheral’ Eurozone countries (i.e., Greece, Spain, Portugal and Ireland), which were under heavy recession after the economic crisis in 2009. Especially in Greece, where the crisis was the most severe across Europe, the austerity measures affected mainly people with chronic diseases. As a result, the urgency to tackle the threat of chronic diseases in Greece by promoting public health and providing effective chronic care while flattening the rising health care expenditure is eminent. In many European countries, integrated care is seen as a means to achieve this.The aim of this paper was to support Greek health policy makers to develop an action plan from 2015 onwards, to integrate care by bridging local policy context and needs with knowledge and experience from other European countries. To achieve this aim, we adopted a conceptual framework developed by the World Health Organization on one hand to analyse the status of integrated care in Greece, and on the other to develop an action plan for reform. The action plan was based on an analysis of the Greek health care system regarding prerequisite conditions to integrate care, a clear understanding of its context and successful examples of integrated care from other European countries. This study showed that chronic diseases are poorly addressed in Greece and integrated care is in embryonic stage.Greek policy makers have to realise that this is the opportunity to make substantial reforms in chronic care. Failing to reform towards integrated care would lead to the significant risk of collapse of the Greek health care system with all associated negative consequences. The action plan provided in this paper could support policy makers to make the first serious step to face this challenge. The details and specifications of the action plan can only be decided by Greek policy makers in close cooperation with other health and social care partners. This is the appropriate time for doing so.

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Integrated care as a priority of the Basque Strategy for Chronic Diseases: the Bidasoa Integrated Healthcare Organisation

Cited by 2 publications

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A system-wide transformation towards integrated care in the Basque Country: A realist evaluation

A system-wide transformation towards integrated care in the Basque Country: A realist evaluation

Bridging knowledge to develop an action plan for integrated care for chronic diseases in Greece

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