Patient-centeredness of integrated care programs for people with multimorbidity. Results from the European ICARE4EU project

Heide, Iris van der; Snoeijs, Sanne; Quattrini, Sabrina; Struckmann, Verena; Hujala, Anneli; Schellevis, François G.; Rijken, Mieke

doi:10.1016/j.healthpol.2017.10.005

Cited by 73 publications

(70 citation statements)

References 37 publications

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“…Below, information on materials and methods is reported. A more detailed description of these aspects is provided elsewhere [52,65,66]. They were asked to identify existing integrated care initiatives at a national/regional/local level focusing on MM and to report the related information by filling in an online questionnaire for each eligible program, also with the collaboration of their expert network and program managers/leaders.…”

Section: Methodsmentioning

confidence: 99%

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Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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Introduction. eHealth applications have the potential to provide new integrated care services to patients with multimorbidity (MM), also supporting multidisciplinary care. The aim of this paper is to explore how widely eHealth tools have been currently adopted in integrated care programs for (older) people with MM in European countries, including benefits and barriers concerning their adoption, according to some basic health system characteristics. Materials and Methods. In 2014, in the framework of the ICARE4EU project, expert organizations in 24 European countries identified 101 integrated care programs. Managers of the selected programs completed an online questionnaire on several dimensions, including the use of eHealth. We analyzed data from this questionnaire, in addition to qualitative information from six innovative programs which were studied in depth through case study methodology, according to characteristics of national health systems: a national health model (financing system), overall strength of primary care (PC) (structure/service delivery process), and level of (de)centralization of health system (executive powers in a country). Results. 85 programs (out of 101) adopted at least one eHealth tool, and 42 of these targeted explicitly older people. In most cases, Electronic Health Records (EHRs) were used and some benefits emerged like improved care management and integration, although inadequate funding mechanisms represented a major barrier. The analysis by health system characteristics showed a greater adoption of eHealth applications in decentralized countries, in countries with a National Health Service (NHS) model, and in countries with a strong/medium level of PC development. Conclusions. Although in the light of some limitations, findings indicate a relation between implementation of care programs using eHealth tools and basic characteristics of health systems, with decentralization of a health system, NHS model, and strong/medium PC having a key role. However adaptations of European health systems seem necessary, in order to provide a more innovative and integrated care.

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Section: Methodsmentioning

confidence: 99%

“…Limitations. This study presents some limitations, as well as the overall ICARE4EU project [52,65,66]. Our overview of relevant programs in European countries is based only on the impact of eHealth technologies as perceived by service/program managers/leaders, without including reports from patients, caregivers, and care providers.…”

Section: 5mentioning

confidence: 99%

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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“…El cuidado centrado en la enfermedad debe cambiar hacia el cuidado centrado en la persona. Esta nueva concepción de cuidado, considera respetar las preferencias, necesidades y valores del paciente e incorporarlos en las decisiones clínicas (Van der Heide et al, 2018). Existe consenso en algunos elementos claves propios de este enfoque, que consisten en: una revisión periódica de los problemas de las personas de acuerdo a sus circunstancias individuales, enfoque en la calidad de vida y funcionalidad, tanto como el control de Barros et al…”

Section: Cambios a Nivel Mundialunclassified

“…En general, los sistemas de salud han organizado su enfrentamiento de las enfermedades crónicas en torno a diagnósticos únicos y las decisiones terapéuticas se han dirigido casi exclusivamente a mejorar parámetros clínicos (Van der Heide et al, 2018), con un enfoque y acercamiento centrado en la enfermedad. Esto conduce a que los pacientes con multimorbilidad reciban un cuidado fragmentado, ineficiente, inefectivo y en algunas ocasiones incluso dañino (Palmer et al, 2018).…”

Section: Introductionunclassified

“…Esto conduce a que los pacientes con multimorbilidad reciban un cuidado fragmentado, ineficiente, inefectivo y en algunas ocasiones incluso dañino (Palmer et al, 2018). Por esto la recomendación es que los sistemas de salud cambien su modelo de atención hacia uno donde el cuidado está centrado en la persona (Van der Heide et al, 2018). El esfuerzo por implementar este cambio es relativamente reciente y está en pleno desarrollo, por lo que aún no existe mucha evidencia que permita recomendar modelos de implementación maduros.…”

Section: Introductionunclassified

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Cambios en el modelo de atención de personas con multimorbilidad crónica: una revisión narrativa

URZUA

Pichard²,

Yuraszeck³

et al. 2019

ARS med

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Muchos países deben enfrentarse al rápido aumento de personas viviendo con alguna condición crónica de salud. En Chile, según datos entregados por la última encuesta nacional de salud, se ha estimado que la población con alguna condición crónica es de 11 millones de personas, de las cuales un 81% presenta multimorbilidad. Este grupo tiene una menor calidad de vida, una mayor mortalidad ajustada por edad, mayor utilización de recursos del sistema de salud, así como un mayor riesgo de hospitalización y una estadía hospitalaria más prolongada. Metodología: revisión narrativa de la literatura para lograr identificar como se ha organizado el cuidado de los pacientes con multimorbilidad a lo largo del tiempo y como se han ido desarrollando estrategias que buscan un abordaje distinto. Resultados: los sistemas de salud se han organizado con un enfoque centrado en la enfermedad, lo que genera que los pacientes reciban un cuidado fragmentado, ineficiente e inefectivo, sin lograr dimensionar la complejidad de la persona y su contexto biopsicosocial. Los sistemas de salud, principalmente en Europa han desarrollado diversas iniciativas que buscan cambiar la perspectiva desde el cuidado centrado en la enfermedad al cuidado centrado en la persona Conclusiones: se puede concluir que la multimorbilidad es un problema que afecta a millones de personas en el mundo y que los servicios y sistemas de salud necesitan hacer un cambio hacia un modelo centrado en la persona de forma de dar respuestas a las necesidades de este grupo de pacientes.

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Priorities for Arab Health Policy Makers

El-Saharty¹,

Liu²

2021

Handbook of Healthcare in the Arab World

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Patient-centeredness of integrated care programs for people with multimorbidity. Results from the European ICARE4EU project

Abstract: In many European countries innovative approaches are applied to increase patient-centeredness of care for people with multimorbidity. To assess their potential benefits and conditions for implementation, thorough process and outcome evaluations of programs are urgently needed.

Cited by 73 publications

References 37 publications

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Cambios en el modelo de atención de personas con multimorbilidad crónica: una revisión narrativa

Priorities for Arab Health Policy Makers

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