TY - JOUR
KW - Complex needs
KW - Delivery of care
KW - integrated care
KW - person-centred care
KW - Thick description
AU - T. Czypionka
AU - M. Kraus
AU - M. Reiss
AU - E. Baltaxe
AU - J. Roca
AU - S. Ruths
AU - J. Stokes
AU - V. Struckmann
AU - R. T. Haček
AU - A. Zemplényi
AU - M. Hoedemakers
AU - Rutten- van Mölken
A1 - 
AB - BACKGROUND: As the prevalence of multi-morbidity increases in ageing societies, health and social care systems face the challenge of providing adequate care to persons with complex needs. Approaches that integrate care across sectors and disciplines have been increasingly developed and implemented in European countries in order to tackle this challenge. The aim of the article is to identify success factors and crucial elements in the process of integrated care delivery for persons with complex needs as seen from the practical perspective of the involved stakeholders (patients, professionals, informal caregivers, managers, initiators, payers). METHODS: Seventeen integrated care programmes for persons with complex needs in 8 European countries were investigated using a qualitative approach, namely thick description, based on semi-structured interviews and document analysis. In total, 233 face-to-face interviews were conducted with stakeholders of the programmes between March and September 2016. Meta-analysis of the individual thick description reports was performed with a focus on the process of care delivery. RESULTS: Four categories that emerged from the overarching analysis are discussed in the article: (1) a holistic view of the patient, considering both mental health and the social situation in addition to physical health, (2) continuity of care in the form of single contact points, alignment of services and good relationships between patients and professionals, (3) relationships between professionals built on trust and facilitated by continuous communication, and (4) patient involvement in goal-setting and decision-making, allowing patients to adapt to reorganised service delivery. CONCLUSIONS: We were able to identify several key aspects for a well-functioning integrated care process for complex patients and how these are put into actual practice. The article sets itself apart from the existing literature by specifically focussing on the growing share of the population with complex care needs and by providing an analysis of actual processes and interpersonal relationships that shape integrated care in practice, incorporating evidence from a variety of programmes in several countries.
AD - Institute for Advanced Studies, Josefstädter Straße 39, 1080, Vienna, Austria.; London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.; Institute for Advanced Studies, Josefstädter Straße 39, 1080, Vienna, Austria. kraus@ihs.ac.at.; Institute for Advanced Studies, Josefstädter Straße 39, 1080, Vienna, Austria.; Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Villarroel 170, Barcelona,, 08036,, Catalonia, Spain.; Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Villarroel 170, Barcelona,, 08036,, Catalonia, Spain.; University of Bergen, Postboks 7804, 5020, Bergen, Norway.; University of Manchester, 7th Floor, Williamson Building, Oxford Road, Manchester, M13 9P, UK.; Berlin University of Technology, Strasse des 17. Juni 135 (H80), 10623, Berlin, Germany.; Ministry of Health, Ksaver 200a, 10000, Zagreb, Croatia.; Syreon Research Institute, Mexikoi str. 65/A, 1142, Budapest, Hungary.; Erasmus University Rotterdam, P.O.Box 1738, 3000, DR, Rotterdam, The Netherlands.; Erasmus University Rotterdam, P.O.Box 1738, 3000, DR, Rotterdam, The Netherlands.
BT - BMC health services research
C5 - Education & Workforce; Healthcare Disparities
CP - 1
DO - 10.1186/s12913-020-05917-9
IS - 1
JF - BMC health services research
LA - eng
M1 - Journal Article
N2 - BACKGROUND: As the prevalence of multi-morbidity increases in ageing societies, health and social care systems face the challenge of providing adequate care to persons with complex needs. Approaches that integrate care across sectors and disciplines have been increasingly developed and implemented in European countries in order to tackle this challenge. The aim of the article is to identify success factors and crucial elements in the process of integrated care delivery for persons with complex needs as seen from the practical perspective of the involved stakeholders (patients, professionals, informal caregivers, managers, initiators, payers). METHODS: Seventeen integrated care programmes for persons with complex needs in 8 European countries were investigated using a qualitative approach, namely thick description, based on semi-structured interviews and document analysis. In total, 233 face-to-face interviews were conducted with stakeholders of the programmes between March and September 2016. Meta-analysis of the individual thick description reports was performed with a focus on the process of care delivery. RESULTS: Four categories that emerged from the overarching analysis are discussed in the article: (1) a holistic view of the patient, considering both mental health and the social situation in addition to physical health, (2) continuity of care in the form of single contact points, alignment of services and good relationships between patients and professionals, (3) relationships between professionals built on trust and facilitated by continuous communication, and (4) patient involvement in goal-setting and decision-making, allowing patients to adapt to reorganised service delivery. CONCLUSIONS: We were able to identify several key aspects for a well-functioning integrated care process for complex patients and how these are put into actual practice. The article sets itself apart from the existing literature by specifically focussing on the growing share of the population with complex care needs and by providing an analysis of actual processes and interpersonal relationships that shape integrated care in practice, incorporating evidence from a variety of programmes in several countries.
PY - 2020
SN - 1472-6963; 1472-6963
SP - 1102
T1 - The patient at the centre: evidence from 17 European integrated care programmes for persons with complex needs
T2 - BMC health services research
TI - The patient at the centre: evidence from 17 European integrated care programmes for persons with complex needs
U1 - Education & Workforce; Healthcare Disparities
U2 - 33256723
U3 - 10.1186/s12913-020-05917-9
VL - 20
VO - 1472-6963; 1472-6963
Y1 - 2020
Y2 - Nov 30
ER -