The performance of integrated health care networks in continuity of care: a qualitative multiple case study of COPD patients

Waibel, Sina; Vargas, Íngrid; Aller, Marta-Beatriz; Gusmão, Renata Castro; Henao, Diana Marcela Ossa; Vázquez, María Luisa

doi:10.5334/ijic.1527

Cited by 27 publications

(45 citation statements)

References 44 publications

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“…Conversely, loss of identity,17 poor continuity of care from health professionals, poor communication between members of the healthcare team,38 exclusion from social networks and socioeconomic disadvantage are equally recognised as key barriers 39. These influences are associated with reduced coping ability, decreased help seeking,40 the need to continually repeat medical history and are barriers to develop trusting relationships with health professionals 41. In comparison with other qualitative Australian studies into the patient’s experience of COPD, beneficial impacts were reported when patients felt supported by community members and health professionals,33 42 43 connected to people and nature,42 felt a strong sense of community43 and felt listened to by health professionals 44…”

Section: Discussionmentioning

confidence: 99%

Benefits of the ‘village’: a qualitative exploration of the patient experience of COPD in rural Australia

2019

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ObjectivesThis study sought to explore patients’ experiences of living with, and adapting to, chronic obstructive pulmonary disease (COPD) in the rural context. Specifically, our research question was ‘What are the barriers and facilitators to living with and adapting to COPD in rural Australia?’DesignQualitative, semi-structured interviews. Conversations were recorded, transcribed verbatim and analysed using thematic analysis following the COnsolidated criteria for REporting Qualitative research guidelines.SettingPatients with COPD, admitted to a subregional hospital in Australia were invited to participate in interviews between October and November 2016.Main outcome measuresThemes were identified that assisted with understanding of the barriers and facilitators to living with, and adapting to, COPD in the rural context.ResultsFour groups of themes emerged: internal facilitators (coping strategies; knowledge of when to seek help) and external facilitators (centrality of a known doctor; health team ‘going above and beyond’ and social supports) and internal/external barriers to COPD self-management (loss of identity, lack of access and clear communication, sociocultural challenges), which were moderated by feelings of inclusion or isolation in the rural community or ‘village’.ConclusionsOur findings suggest that community inclusion enhances patients’ ability to cope and ultimately self-manage COPD. This is facilitated by living in a supportive ‘village’ environment, and included a central, known doctor and a healthcare team willing to go ‘above and beyond’. Understanding, or supplementing, these social networks within the broader social structure may assist people to manage chronic disease, regardless of rural or metropolitan location.

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Section: Discussionmentioning

confidence: 99%

Benefits of the ‘village’: a qualitative exploration of the patient experience of COPD in rural Australia

2019

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“…A conformação em RAS, tendência internacional, visa a superar o cuidado fragmentado, os custos elevados, com expectativa de maior eficiência ao sistema 20,21,22 . Quando baseada em território, a RAS reduz as desigualdades locorregionais e as iniquidades de acesso 9 .…”

Section: Discussionunclassified

Avaliação da rede de atenção ao portador de hipertensão arterial: estudo de uma região de saúde

et al. 2017

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Resumo: No contexto das políticas públicas de saúde, a rede de atenção é uma estratégia que visa a promover a equidade do acesso das pessoas aos serviços e reduzir a sua fragmentação. O objetivo foi avaliar o grau de desenvolvimento dos componentes de uma rede de atenção à saúde para hipertensão. Trata-se de um estudo avaliativo do tipo ex-ante, de corte transversal, voltado à implantação da Rede de Atenção à Saúde das pessoas com doenças crônicas com a aplicação de questionário a 17 gestores de saúde dos municípios que formam a maior região de saúde de Mato Grosso do Sul, Brasil. O questionário é constituído de 65 questões que contemplam os cinco componentes: Atenção Primária à Saúde; Atenção Especializada; Sistemas de Apoio; Sistemas Logísticos; e Governança. Foram realizados testes estatísticos descritivos e a classificação dos serviços prestados em cada componente por meio do teste de Friedman, seguido pelo pós-teste de Student-Newman-Keuls, com nível de significância de 5%. Os resultados foram distribuídos em quartis e apresentados em gráficos Boxplot. Foram estabelecidas correlações entre as dimensões. Resultados apontam que os componentes estão no grau intermediário de implantação, com baixo desenvolvimento nos quesitos necessários para a constituição de redes. A Atenção Primária à Saúde não coordena o cuidado, e os componentes Atenção Especializada e Governança apresentaram os piores resultados. Os achados apontam predomínio de serviços instalados ainda distantes das práticas necessárias para a composição de redes de atenção à saúde, podendo comprometer a sua implantação.

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“…Integrated care has system, organizational and clinical levels [20][21][22]. The system level includes both vertical and horizontal integration.…”

Section: Integrated Carementioning

confidence: 99%

“…Although, there is certainly overlap with self management, the focus of care coordination on organizational aspects of patient care [36] gives it a different spin. Continuity of care, a goal of care coordination, has three aspects: 1) Continuity of clinical management; 2) Continuity of information; and 3) Relational continuity [22]. Like self-management, care coordination can be considered a component of integrated care.…”

Section: Care Coordinationmentioning

confidence: 99%

Integrated Care: What does this Mean for the COPD Patient?

Williams¹,

Wilcox²,

ZuWallack³

et al. 2016

Chron Obstruct Pulmon Dis

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Despite remarkable advances in medicine and technology, the management of the patient with COPD is often inefficient and fragmented. Optimizing care for these individuals requires that a proactive, patient-centered, defragmented and integrated plan of care. Integrated care, which draws heavily from the chronic care model, incorporating holistic, self-management and care coordination principles to meet the needs of the complex COPD patient, is a desirable approach to improving medical management. The relationship of integrated care to other, similar conceptual models, including self-management, disease management, care coordination, and patient centered medical home is discussed.

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The performance of integrated health care networks in continuity of care: a qualitative multiple case study of COPD patients

Cited by 27 publications

References 44 publications

Benefits of the ‘village’: a qualitative exploration of the patient experience of COPD in rural Australia

Benefits of the ‘village’: a qualitative exploration of the patient experience of COPD in rural Australia

Avaliação da rede de atenção ao portador de hipertensão arterial: estudo de uma região de saúde

Integrated Care: What does this Mean for the COPD Patient?

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