Towards integrated care for chronic conditions: Dutch policy developments to overcome the (financial) barriers

Tsiachristas, Apostolos; Hipple-Walters, Bethany; Lemmens, Karin; Nieboer, Anna P.; Mölken, Maureen P.M.H. Rutten-van

doi:10.1016/j.healthpol.2010.10.013

Cited by 52 publications

(64 citation statements)

References 22 publications

(31 reference statements)

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“…These indicators can be used in price negotiations between insurers and care groups. Care provided under bundled payments is free of charge for patients (Tsiachristas, 2010).…”

Section: Integrated Care and Bundled Payments In The Netherlandsmentioning

confidence: 99%

Individual Responsibility and Community Solidarity — The Swiss Health Care System

Biller‐Andorno

Zeltner

2015

N Engl J Med

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“…These indicators can be used in price negotiations between insurers and care groups. Care provided under bundled payments is free of charge for patients (Tsiachristas, 2010).…”

Section: Integrated Care and Bundled Payments In The Netherlandsmentioning

confidence: 99%

Individual Responsibility and Community Solidarity — The Swiss Health Care System

Biller‐Andorno

Zeltner

2015

N Engl J Med

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“…In general, systems for delivery of health care have focused attention on the treatment of acute problems (World Health Organization, 2002), which often results in inadequate delivery of services to address chronic conditions. Globally, the prevalence rates of chronic diseases are increasing, and there is a need for changes in delivery of health care to address the rising rates (Tsiachristas, Hipple-Walters, Lemmens, Nieboer, & Rutten-Van Molken, 2010). An integrated and multidisciplinary approach to management of chronic diseases is a means of delivering adequate, long-term, patient-centered services (Tsiachristas et.…”

Section: Prevalence Of Chronic Diseasementioning

confidence: 99%

Efficacy of chronic disease self-management among low-income Black males with behavioral health disorders: Pilot study

Collard

Robinson-Dooley

Patrick

et al. 2017

JGPHA

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Background: This study examined the effectiveness of Stanford University's Chronic Disease Self-management Program (CDSMP) among men living with co-morbidities of chronic physical health disease and behavioral health disorders. Methods:The study was conducted at a community-based, non-profit organization in partnership with a large suburban university. Two pilot studies were completed with the population of interest. Low-income adult males with behavioral health disorders were recruited to participate in the program provided by a local behavioral health agency. Facilitators trained in the CDSMP program administered it at the agency site, and participants attended weekly meetings. Descriptive data collected included health history, demographic information, and assessments of knowledge with the Chronic Disease Self-Efficacy Scale and the Chronic Disease Self-Management Questionnaire created by the Stanford Patient Education Research Center. Due to the small sample size, n=12, the Wilcoxon signed rank test was used to evaluate before and after differences in the sample.Results: For the participants, there were increases in overall activity, stretching activities, and equipment activities. Additionally, participants experienced a decrease in the number of days affected by poor physical or mental health. However, there was no significant increase in perceived self-efficacy, a factor in patient confidence and possibly compliance. Limitations included the small sample size, lack of a control group, and convenience sampling. Conclusions:Various aspects of the program were helpful to some participants, but cultural factors made other areas less compatible for this population. A larger study, utilizing a comparison group, could generate data relevant to hypotheses based on these observations. By collecting qualitative data, focus groups could contribute to understanding the experiences and needs of the participants. Development of a curriculum for self-management of chronic disease with a focus on intercultural competence is presently of interest.

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“…12 Hence, public policies for care for the elderly can benefit greatly from using constructs to evaluate clinical, psychological and social characteristics that simultaneously represent the major geriatric syndromes and the more recently studied aspects of senescence and senility. 8,[12][13][14] The purpose of this study was to identify groups of elderly people at the geriatric outpatient clinic of Hospital de Clínicas,…”

Section: According To Data Published By the United Nations Populationmentioning

confidence: 99%

“…3,8,9,11,13,15,21 Thus, although development of profiles identifying groups that are at most risk of functional impairment may not be of immediate relevance to family members, physicians or caregivers, whose attention is focused on the individual, it allows strategies for care of the elderly to be planned. More recently, studies have correlated vulnerability and functionality to the concept of frailty among the elderly.…”

Section: 4152122mentioning

confidence: 99%

Cluster analysis to identify elderly people's profiles: a healthcare strategy based on frailty characteristics

et al. 2014

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CONTEXT AND OBJECTIVES: The new social panorama resulting from aging of the Brazilian population is leading to significant transformations within healthcare. Through the cluster analysis strategy, it was sought to describe the specific care demands of the elderly population, using frailty components. DESIGN AND SETTING: Cross-sectional study based on reviewing medical records, conducted in the geriatric outpatient clinic, Hospital de Clínicas, Universidade Estadual de Campinas (Unicamp). METHODS: Ninety-eight elderly users of this clinic were evaluated using cluster analysis and instruments for assessing their overall geriatric status and frailty characteristics. RESULTS:The variables that most strongly influenced the formation of clusters were age, functional capacities, cognitive capacity, presence of comorbidities and number of medications used. Three main groups of elderly people could be identified: one with good cognitive and functional performance but with high prevalence of comorbidities (mean age 77.9 years, cognitive impairment in 28.6% and mean of 7.4 comorbidities); a second with more advanced age, greater cognitive impairment and greater dependence (mean age 88.5 years old, cognitive impairment in 84.6% and mean of 7.1 comorbidities); and a third younger group with poor cognitive performance and greater number of comorbidities but functionally independent (mean age 78.5 years old, cognitive impairment in 89.6% and mean of 7.4 comorbidities). CONCLUSION: These data characterize the profile of this population and can be used as the basis for developing efficient strategies aimed at diminishing functional dependence, poor self-rated health and impaired quality of life. RESUMO CONTEXTO E OBJETIVOS:O panorama social do envelhecimento da população brasileira promete transformações significativas na atenção à saúde. Por meio da estratégia de análise por conglomerados (cluster), procurou-se descrever demandas de cuidados na população de idosos, utilizando componentes da fragilidade. TIPO DE ESTUDO E LOCAL: Estudo transversal baseado em revisão de registros médicos, realizado no Ambulatório de Geriatria do Hospital de Clínicas da Universidade Estadual de Campinas (Unicamp).MÉTODOS: Foram analisados 98 idosos usuários deste ambulatório por meio da análise de conglomerados, utilizando instrumentos para a avaliação do status geriátrico global e das características de fragilidade. RESULTADOS: As variáveis que mais fortemente influenciaram a formação dos conglomerados foram idade, capacidades funcional e cognitiva, presença de comorbidades e número de medicamentos utilizados, sendo o modelo com quatro agrupamentos estatisticamente mais robusto. Podem-se identificar três grupos principais de idosos, o primeiro de bom desempenho cognitivo e funcional, porém com elevada prevalência de comorbidades (idade média 77.9 anos, 28.6% com déficit cognitivo, média de 7.4 comorbidades); outro caracterizado por idade mais avançada, maior comprometimento cognitivo e maior dependência (idade média 88.5 anos, 84.6% com dé...

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Towards integrated care for chronic conditions: Dutch policy developments to overcome the (financial) barriers

Cited by 52 publications

References 22 publications

Individual Responsibility and Community Solidarity — The Swiss Health Care System

Individual Responsibility and Community Solidarity — The Swiss Health Care System

Efficacy of chronic disease self-management among low-income Black males with behavioral health disorders: Pilot study

Cluster analysis to identify elderly people's profiles: a healthcare strategy based on frailty characteristics

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