1 / 23

CADENZA Symposium 2009 Primary Care and Older Persons Medical and Social Integration

CADENZA Symposium 2009 Primary Care and Older Persons Medical and Social Integration. Dr Lam Ching-choi Haven of Hope Christian Service 6 October 2009. 4 Quadrants and Gaps in Medical – Social Integration. Medical. Social. DH HA. SWD NGOs. Gaps b/w medical and social

claribele
Download Presentation

CADENZA Symposium 2009 Primary Care and Older Persons Medical and Social Integration

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. CADENZA Symposium 2009Primary Care and Older PersonsMedical and Social Integration Dr Lam Ching-choi Haven of Hope Christian Service 6 October 2009

  2. 4 Quadrants and Gaps in Medical – Social Integration Medical Social DH HA SWD NGOs • Gaps b/w medical • and social • Gaps b/w public • and private • Inefficient and • ineffective Public Fee for Service GPs Private

  3. The Drivers of the 4 Quadrants Medical Social • Drivers • Reduce case load, hospitalisation • Support GPs income • Provide medical service • Have choices SWD NGOs DH HA Public (1) (3) (4) (2) Fee for Service Private GPs

  4. The Ideal Model of Medical – Social Integration Provider Perspectives • Full Integration Model • Addresses the drivers of the 4 quadrants • Need of a Service Delivery model (case • management) • Need for appropriate Service Philosophy for the Delivery model • (trans-disciplinary team) • Need for a financially viable model (resource allocation; sustainable) Medical Social SWD NGOs DH HA Public (1) (3) Full Integration Model (4) (2) Fee for Service Private GPs

  5. The Ideal Model of Medical – Social Integration User Perspectives • R Person centred • user choices • timely provision • need based • Promotion of self-care de-professionalisation of care • Prevention of deterioration on-going maintenance programmes

  6. The Ideal Model of Medical – Social Integration Funder Perspectives • Cost effective • measurable indicators • ‘value for money’ • no duplication of funded services • Evidence based • proven interventions • Sustainable • co-payment

  7. GovernmentExamples Medical Social SWD NGOs • Medical-social in Public • IDSP • CRDC • Public-Private in Medical • PPPs • Public-Private in Social • Self-financing RCHEs DH HA IDSP CRDC Public (1) (3) Full Interation Model Self Financing PPPs (2) (4) Private Fee for Service GPs Hardly any service with more than 2 quadrant involvement; Hardly any medical-social in private

  8. HOHCS Examples Haven of Hope EHCCS • SWD purchases service fromHOHCS to provide social, nursing and allied health services • Somewhat public-private in social service • - HOHCS keeps surplus, if any; however, • present funding not enough, may not be • sustainable to provide appropriate level • of service • - For Funder - cost effective? no duplication • of funded service? presently, fees at • nominal, sustainable?

  9. HOHCS Examples Haven of Hope EHCCS • HOHCS’ Service Delivery Model • and Service Philosophy - Strong trans- disciplinary team of allied health, nursing, social workprovides case management and case conference aiming towards client’s self-care Case Conference with Trans-disciplinary team

  10. HOHCS Examples Haven of Hope EHCCS • HOHCS’ Service Delivery Model • and Service Philosophy - For Users – person centred, timely provision, need-based; carers’ involvement; promotion of self-care; prevention of deterioration

  11. HOHCS Examples Haven of Hope EHCCS • Supported with purchase of service for psycho-geri • service from HA; optometry, dietetics, dental screening • from HOHCS’ units - Medical-social interface limited to psycho-geri thru’service purchase from HA - Other medical/health services supported by HOHCS - Private medical sector not involved

  12. HOHCS Examples Haven of Hope DECS – satellitecentresof DECC • Accessibility for early detection • of health and social care needs, • and their prevention at local • communities of housing estates • Early and timely detection of • medical care needs from • regular health check and • available health consultations

  13. HOHCS Examples Haven of Hope DECS – satellitecentresof DECC • Simple rehab for a fee • for HA discharged • patients • Isolated singletons have • more social interactions when • health needs are addressed

  14. HOHCS Examples Haven of Hope DECS – satellitecentresof DECC • Development ofa network • of ‘healthier’ older persons • caring their weaker • members

  15. HOHCS Examples Haven of Hope DECS – satellitecentresof DECC • - HOHCS initiative of using medical and social • integration • Essentially an earlydetection primary care service • - No particular funding from government for service • No recognition of chronic healthcare needs at • service

  16. HOHCS Examples Healthy City, CHDs & Clinics • OutreachingMedicine services to residential homes • and social centres Western Medicine Chinese Medicine

  17. HOHCS Examples Healthy City, CHDs & Clinics • Collaborations - CGAT stable HT and diabetes • patients for medical care in clinics and lifestyle • classes and support

  18. HOHCS Examples Healthy City, CHDs & Clinics • Community building and large scale wellness promoting • and early detection programmes using social work • approaches Awareness, Prevention and Early detection of Cognitive impairment (APEC) project Falls prevention (Carers training )

  19. HOHCS Examples Healthy City, CHDs & Clinics • HOHCS initiative of private, public, medical and • social integration • Healthy City – District Council & HOHCS funding • CHDs – Jockey Club & Comm Chest & HOHCS • Clinics – self-financing • Essentially an earlydetection, health promotion • primary care service • - No particular funding from government

  20. The Ideal Model of Medical – Social Integration Obstacles & Hindrances • Lack of full and formal recognition by Govt on health elements in elderly social centres • - manpower • - space • Lack of full and formal recognition on the social • determinants of wellness and well-being in • primary health services • ‘All or nothing’ financing arrangements hindering public-private interface

  21. The Ideal Model of Medical – Social Integration Proposed Service • Characteristics of the Service • timely and ready care and a supportive network of professionals, family members, fellow sufferers and volunteers • facilitates and supports self-care in the long run • reduces the progression and complications of the chronic disease(s) • delays onset of other non-communicable diseases

  22. The Ideal Model of Medical – Social Integration Proposed Service • Service Infrastructure • A coordinating centre/team • A network of services that include all the • elements of primary care, including medical, • nursing, allied health and social services to serve • targetted older persons with targetted services • A funding mechanism that involves private • medical practitioners and co-payment • 4.An interfacing platform for information flow

  23. CADENZA Symposium 2009Primary Care and Older PersonsMedical and Social Integration Dr Lam Ching-choi Haven of Hope Christian Service 6 October 2009 End of Presentation Thank You

More Related