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How do integrated care initiatives impact on consumer experience?. Petra Bywood, Lynsey Brown & Jodie Oliver-Baxter European Forum for Primary Care, 9-10 September 2013, Istanbul. www.phcris.org.au. Fragmented care. Services are hard to find GPs unaware of patients’ hospital visits

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How do integrated care initiatives impact on consumer experience

How do integrated care initiatives impact on consumer experience?

Petra Bywood, Lynsey Brown & Jodie Oliver-Baxter

European Forum for Primary Care, 9-10 September 2013, Istanbul

www.phcris.org.au


Fragmented care
Fragmented care

Services are hard to find

GPs unaware of patients’ hospital visits

Vulnerable populations miss out on services

Conflicting advice for multimorbidity

Lack of coordination across sectors

   Duplications / Gaps / Adverse Events

Patients want accessible, affordable, coordinated, integrated local health services

www.phcris.org.au


Method
Method

Literature review

Electronic databases, grey literature, websites, organisation publications

Search Terms

Integration, integrated care (synonyms)

Literature

Publicly available, last 5 years

Peer-reviewed articles, program papers, reports, government documents

www.phcris.org.au


What do patients value most
What do patients value most?

Continuityof care, specific personnel, care teams

After-hours access to care & advice

Sensitivityto needs (cultural)

Involvementin medical decision-making

Links between health and social services

Co-locationof services (multidisciplinary)

www.phcris.org.au


Key mechanisms of integration
Key mechanisms of integration

Structural arrangements

Shared vision

Effective communication & support

Shared culture

Collaborative practice

Funding models

Governance structures

Tailored service delivery

Common care processes

Information-sharing platforms

www.phcris.org.au


Australian examples of integrated care
Australian examples of integrated care

Jackson et al. (2010) GPs with special interests impacting on complex diabetes care. AFP vol. 39

Consan Consulting (2012) Evaluation of the GP Super Clinics program 2007-2008. Canberra: Dept of Health and Ageing

  • Australian Comprehensive PHC(Jackson et al. 2010)

    • Indigenous attendance increased

    • Increased glycaemic control

  • GP Super Clinics (Consan Consulting 2012)

    • 83% patients attended because of access to wide range of providers

    • 66% patients reported staff coordinated all aspects of their care

    • Referrals, access, communication improved

www.phcris.org.au


Challenges
Challenges

Limitations of the research

Lack of consensus/consistency

Inadequatetimefor follow-up

Barriers to integration

Lack of clarity in roles,responsibilities

Lack ofengagementwith other sectors

Lack ofsustained funding for integration

Time-consumingprocesses

www.phcris.org.au


Take away messages
Take-away messages

It’s complicated!

Better integration for patients means:

At local (micro) level: more attention to change processes, communication modalities and care pathways

At organisational (meso) level: tailored support for care providers, engagement across health and social care

At systems (macro) level: policies that enable organisations & providers to deliver integrated care

www.phcris.org.au


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