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Erica Barbazza & Viktoria Stein Health Services Delivery Programme

Context and challenges for coordinated/integrated health services delivery (CIHSD) in the Baltic Region. Erica Barbazza & Viktoria Stein Health Services Delivery Programme Division of Health Systems and Public Health WHO Regional Office for Europe.

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Erica Barbazza & Viktoria Stein Health Services Delivery Programme

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  1. Context and challenges for coordinated/integrated health services delivery (CIHSD) in the Baltic Region • Erica Barbazza& Viktoria Stein • Health Services Delivery Programme • Division of Health Systems and Public Health • WHO Regional Office for Europe Health System Development Perspectives: Problems of equity and integrated care Vilnius, Lithuania, October 28th 2013

  2. Presentation overview What is coordinated/integrated health services delivery (CIHSD)? Lessons from implementation: Experiences from the Baltic countries WHO/EURO’s work plan to developing a Framework for Action towards CIHSD

  3. Patient vignette: scenario 1 On-site lab Pharmacy Complexity: Low Fragmentation: Low Patient capacity: High Coordination need: Low PHC led prevention GP visit

  4. Patient vignette: scenario 2 Complexity: High Fragmentation: Moderate Patient capacity: Low Coordination need: Extensive 85 year old male, multi-morbidities, mobility challenges, regular contact with multiple providers, taking multiple medications for conditions Graphics byKatrinGasior and Georg Ruppe, European Centre 2009

  5. What is coordinated/integrated health services delivery (CIHSD)? The management and delivery of health services such that people receive a continuum of services through the levels and sites of care within the health system, and according to their needs. Services Settings • Health Protection • Health Promotion • Disease Prevention • Diagnosis • Treatment • Long-term care • Rehabilitation • Palliative care • Public health • Primary care • Secondary care • Specialist care • Community, home & social care • Pharmacies Source: WHO/EURO, Roadmap, 2013

  6. Why is CIHSD necessary? Morbidity Demography Technology Preferences Financial constraints Path dependencies Path dependency Adapted from Dr. Amelung, 2013, Tallinn, Estonia

  7. Where are we now? Estonian eHealthsystem National Prevention/promo in PHC; LVA Local Multidisciplinary centres, EST Eastern Lithuanian Cardiology Programme Provider networks, LTU

  8. How do CIHSD initiatives take shape?

  9. Example: Eastern Lithuanian Cardiology Programme (ELCP)

  10. How did it take shape? ELCP example continued NATIONAL SUPPORT EXTERNAL AUDIT Situation analysis: epidemiological context, services & Regional needs Implementation: roll-out of activities (infrastructure; education; etc) ? Cont’d roll-out: on-going use of infrastructure; trainings; etc Planning: specifying interventions; targets; aims; etc ADVOCACY

  11. WHO/EURO: supporting Member State transformations towards more CIHSD

  12. Developing a WHO/EURO Framework for Action towards CIHSD Consolidating literature; defining arenas for action Country case studies; lessons from implementation Tools and curriculum for change management

  13. Know of a CIHSD to share? Visit the health services delivery page to submit an initiative towards more CIHSD or help and share the open call for initiatives with your colleagues! Visit: http://www.euro.who.int/en/health-topics/Health-systems/health-service-delivery

  14. THANK YOU To reach the Secretariat directly to send comments or questions please contact CIHSD@euro.who.int Health System Development Perspectives: Problems of equity and integrated care Vilnius, Lithuania, October 28th 2013

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