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Integrated care

About: Integrated care is a research topic. Over the lifetime, 7318 publications have been published within this topic receiving 106960 citations. The topic is also known as: Integrated Delivery of Health Care & Delivery of Health Care, Integrated.


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Journal ArticleDOI
TL;DR: In this paper, the role of marketing as an integrator in integrated care through a marketing mix typology is highlighted, and a conceptual and contextual route is adopted to investigate the relationship between marketing and integrated care.
Abstract: This paper aims to accentuate the role of marketing as an integrator in integrated care through a marketing mix typology. To do so, this paper adopts a conceptual and contextual route to investigat...

34 citations

Journal ArticleDOI
TL;DR: The successful development of a learning health‐care system was to collect, accumulate and analyze data, interpret results, deliver tailored message and take action to change practice.
Abstract: Taiwan renal care system is an evolving learning health-care system. There are four facets of this system. From the early history of dialysis and Taiwan Renal Registry Data System, it facilitates the generation of data to knowledge. National multidisciplinary pre-end-stage renal disease care project and outcome enhances knowledge to practice. Early chronic kidney disease (CKD) programs and 2015 Taiwan CKD clinical guidelines implicate the practice to customer, and then explore the causes of CKD help to resume customer to data. A learning health-care system allows better and safer care at lower cost, enhancement of public health and patient empowerment. The successful development of a learning health-care system was to collect, accumulate and analyze data, interpret results, deliver tailored message and take action to change practice. Through the established database and data analysis, an integrated care system would be able to improve clinical outcomes and achieve the most cost-effectiveness care. Acute kidney injury, CKD with unknown origin, palliative care and kidney transplant are our new focuses to struggle.

34 citations

Journal ArticleDOI
01 Apr 2016-BMJ Open
TL;DR: The intervention does not meet its primary aim, the clinical significance and cost-effectiveness of these small practice-level effects is debatable, and there is an ongoing need to develop effective ways to reduce unnecessary attendances in secondary care for the high-risk population.
Abstract: Objectives To evaluate a multidisciplinary team (MDT) case management intervention, at the individual (direct effects of intervention) and practice levels (potential spillover effects). Design Difference-in-differences design with multiple intervention start dates, analysing hospital admissions data. In secondary analyses, we stratified individual-level results by risk score. Setting Single clinical commissioning group (CCG) in the UK9s National Health Service (NHS). Participants At the individual level, we matched 2049 intervention patients using propensity scoring one-to-one with control patients. At the practice level, 30 practices were compared using a natural experiment through staged implementation. Intervention Practice Integrated Care Teams (PICTs), using MDT case management of high-risk patients together with a summary record of care versus usual care. Direct and indirect outcome measures Primary measures of intervention effects were accident and emergency (AE inpatient non-elective stays, 30-day re-admissions; inpatient elective stays; outpatient visits; and admissions for ambulatory care sensitive conditions. Secondary measures included inpatient length of stay; total cost of secondary care services; and patient satisfaction (at the practice level only). Results At the individual level, we found slight, clinically trivial increases in inpatient non-elective admissions (+0.01 admissions per patient per month; 95% CI 0.00 to 0.01. Effect size (ES): 0.02) and 30-day re-admissions (+0.00; 0.00 to 0.01. ES: 0.03). We found no indication that highest risk patients benefitted more from the intervention. At the practice level, we found a small decrease in inpatient non-elective admissions (−0.63 admissions per 1000 patients per month; −1.17 to −0.09. ES: −0.24). However, this result did not withstand a robustness check; the estimate may have absorbed some differences in underlying practice trends. Conclusions The intervention does not meet its primary aim, and the clinical significance and cost-effectiveness of these small practice-level effects is debatable. There is an ongoing need to develop effective ways to reduce unnecessary attendances in secondary care for the high-risk population.

34 citations

Journal ArticleDOI
01 Oct 2018
TL;DR: In this paper, the authors explored the experiences and views of service users, involved GPs, and navigators on factors influencing uptake and adherence to social prescribing (SP) programs.
Abstract: Background Social prescription is an initiative that aims to link patients in primary care with sources of support within the community and voluntary sector to improve their health, wellbeing, and care experience. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. Most research on social prescribing (SP) has focused on outcome evaluations, resulting in a knowledge gap of factors affecting uptake and adherence. Understanding such factors enables the refinement of programmes, which has the potential to enhance uptake and adherence, reduce health inequalities, and optimise investment. Aim To explore the experiences and views of service users, involved GPs, and navigators on factors influencing uptake and adherence to SP. Design & setting Qualitative interviews were conducted with stakeholders involved in an SP programme in the east of England (Luton). Method Data were collected from semi-structured face-to-face interviews with service users, navigators, and GPs. Thematic analysis was used to analyse the data. Results Factors affecting uptake and adherence to SP were related to patients’ trust in GPs, navigators9 initial phone call, supportive navigators and service providers, free services, and perceived need and benefits. Reported barriers to uptake and adherence were fear of stigma of psychosocial problems, patient expectations, and the short-term nature of the programme. Conclusion This study provides an insight into factors affecting patient uptake and adherence to SP programmes. More research in this field, including patients who refused to participate in SP, is needed.

34 citations

Journal ArticleDOI
01 Feb 2018-Dementia
TL;DR: Understanding of health care professionals’ attitudes and knowledge of the barriers to integrated care for people with advanced dementia is improved to develop collaborative networks to foster improved relationships between health and social care services.
Abstract: People with advanced dementia are frequently bed-bound, doubly incontinent and able to speak only a few words. Many reside in care homes and may often have complex needs requiring efficient and timely response by knowledgeable and compassionate staff. The aim of this study is to improve our understanding of health care professionals' attitudes and knowledge of the barriers to integrated care for people with advanced dementia. In-depth, interactive interviews conducted with 14 health care professionals including commissioners, care home managers, nurses and health care assistants in the UK. Barriers to care for people with advanced dementia are influenced by governmental and societal factors which contribute to challenging environments in care homes, poor morale amongst care staff and a fragmentation of health and social care at the end of life. Quality of care for people with dementia as they approach death may be improved by developing collaborative networks to foster improved relationships between health and social care services.

34 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
202384
2022166
2021672
2020663
2019630
2018663