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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. Services are hard to find GPs unaware of patients’ hospital visits

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How do integrated care initiatives impact on consumer experience?

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  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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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