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Oostra DL, Nieuwboer MS, Melis RJF, Remers TEP, Olde Rikkert MGM, Perry M. DementiaNet facilitates a sustainable transition toward integrated primary dementia care: A long-term evaluation. Alzheimers Dement 2023; 19:5498-5505. [PMID: 37218358 DOI: 10.1002/alz.13154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Care integration is a promising strategy to achieve sustainable health-care systems. With DementiaNet, a 2-year program, we facilitated collaboration between primary health-care professionals. We studied changes in primary dementia care integration during and after DementiaNet participation. METHODS A longitudinal follow-up study was performed. Networks started between 2015 and 2020; follow-up ended in 2021. Quantitative and quantitative data were collected annually to assess quality of care, network collaboration, and number of crisis admissions. Growth modeling was used to identify changes over time. RESULTS Thirty-five primary care networks participated. Network collaboration and quality of care of newly formed networks increased significantly in the first 2 years (respectively, 0.35/year, P < .001; 0.29/year, P < .001) and thereafter stabilized. CONCLUSION Primary care networks improved their collaboration and quality of care during DementiaNet participation, which persisted after the program ended. This indicates that DementiaNet facilitated a sustainable transition toward integrated primary dementia care.
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Affiliation(s)
- Dorien L Oostra
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands
| | - Minke S Nieuwboer
- Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands
- HAN University of Applied Sciences, Academy of Health and Vitality, Nijmegen, The Netherlands
| | - René J F Melis
- Department of Geriatric Medicine, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
- Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands
| | - Toine E P Remers
- Radboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Marcel G M Olde Rikkert
- Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands
- Department of Geriatric Medicine, Radboud university medical center, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
| | - Marieke Perry
- Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands
- Department of Geriatric Medicine, Radboud university medical center, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud university medical center, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
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Choi JW, Yoo AJ. Outcomes of the Pilot Project for Community Care Among Older Adults in South Korea. J Aging Soc Policy 2023:1-18. [PMID: 38007618 DOI: 10.1080/08959420.2023.2284571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/27/2023] [Indexed: 11/27/2023]
Abstract
The Korean government implemented the pilot project for community care for older adults in June 2019. This study investigated the outcomes of the pilot project among Korean older adults by linking survey data from the pilot project with data of Korean National Health Insurance Service. The final sample included 17,801 pilot project participants and 68,145 in a matched comparison group. Pilot program participants experienced an increase of 4.8 days for length of home stay and a reduction of $956 (US) per participant relative to the matched comparison group. Pilot program participants with long-term care insurance who used home care services experienced an increase of 8.9 days for length of home stay and a reduction in $1,177 (US) in total costs, along with a reduction in the admission to long-term care facilities, compared to the matched comparison group. Patients discharged from hospitals indicated an increase of 35.2 days for length of home stay and a reduction of $6,947 (US) in total costs, but a 3.53 times increase in hospital readmissions relative to the matched comparison group. The pilot project for community care resulted in increased length of home stay and reduced total costs among older adults in Korea.
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Affiliation(s)
- Jae Woo Choi
- Community Care Research Center, Health Insurance Research Institute, National Health Insurance Service, Gangwon, Korea
| | - Ae Jung Yoo
- Community Care Research Center, Health Insurance Research Institute, National Health Insurance Service, Gangwon, Korea
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Hu L, Glavin YFW. Integrating Health and Care for Older People in China: What Has Been Accomplished? What is Next? Int J Integr Care 2023; 23:16. [PMID: 36967837 PMCID: PMC10038113 DOI: 10.5334/ijic.7598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Affiliation(s)
- Linlin Hu
- School of Health Policy and Management, Peking Union Medical College, Beijing 100730, China
| | - Ye-Fan Wang Glavin
- School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA
- IJIC Editorial Board, US
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Roest JJ, Welmers-Van de Poll MJ, Van der Helm GHP, Stams GJJM, Hoeve M. A Meta-Analysis on Differences and Associations between Alliance Ratings in Child and Adolescent Psychotherapy. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:55-73. [PMID: 35862768 DOI: 10.1080/15374416.2022.2093210] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The alliance in child and adolescent psychotherapy is widely recognized as an important factor in therapy. Studies on the alliance have increasingly focused on assessment of the alliance as a dyadic construct, measuring both client and therapist alliance ratings. However, cross-informant reports of the alliance in child psychotherapy have not yet been subjected to meta-analysis. Therefore, the present meta-analysis aims to increase knowledge on the degree of convergence and divergence between child, parent, therapist, and observer alliance ratings in child and adolescent psychotherapy. METHODS A series of three-level meta-analyses of 78 studies was conducted to investigate differences and associations between child, parent, therapist, and observer alliance ratings in child and adolescent psychotherapy. RESULTS Findings indicated that children and parents in general rated the alliance more positively than their therapists (d = 0.35, d = 0.72, respectively), and that child-therapist and parent-therapist alliance ratings were moderately correlated (r = .32, r = .23, respectively). Associations between child and therapist ratings and observer ratings were moderate to large (r = .43, r = .53, respectively). CONCLUSIONS It can be concluded that children and parents generally report more positively on the alliance compared to their therapists, which is consistent with research on the alliance in adult populations. The small to moderate associations between alliance ratings indicate that individuals to some extent have a shared perspective on their alliance, and that the various perspectives on alliance should be acknowledged when dealing with children and parents in therapy. Implications for future research are discussed.
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Affiliation(s)
- Jesse J Roest
- Department of Social Work and Applied Psychology, University of Applied Sciences Leiden
| | | | - G H Peer Van der Helm
- Department of Social Work and Applied Psychology, University of Applied Sciences Leiden.,Research Institute Child Development and Education, University of Amsterdam
| | | | - Machteld Hoeve
- Research Institute Child Development and Education, University of Amsterdam
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Sun Y, Zhang X, Han Y, Yu B, Liu H. Evolutionary game model of health care and social care collaborative services for the elderly population in China. BMC Geriatr 2022; 22:616. [PMID: 35879656 PMCID: PMC9317207 DOI: 10.1186/s12877-022-03300-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The synergy of health care and elderly social care organizations has become the focus of the research on integrated health care and social care. This study aims to propose a collaborative strategy among health care and elderly social care service providers. METHODS An evolutionary game model is applied for performance analysis and optimization of the cooperation between health care and elderly social care organizations. The behavioural strategies and the impact of key parameters on promoting the cooperation of the players are presented in detail. RESULTS Simulation experiments and sensitivity analysis results indicate that (1) the behavioural evolution of health care organizations and elderly social care organizations forms three types of integrated health care and social care services, namely, the bilateral cooperation type, health care organization-led type and elderly social care organization-led type. (2) Increasing the additional benefits for cooperation and reducing the additional costs for cooperation can promote the willingness to synergize to provide integrated health care and elderly social care services. At the early stage of evolution, increasing the costs that elderly social care organizations pay to purchase health care services or pay for negotiation in the bilateral cooperation type can provide incentives for health care organizations to cooperate while reducing the cooperation preferences of elderly social care organizations. However, the long-term impact of the costs on the behavioural strategies for cooperation of the two players cannot be determined. CONCLUSION The behavioural decisions on cooperation between health care and elderly social care organizations influence each other; commitment to integration and effective collaboration can be achieved by increasing the additional benefits and reducing the marginal costs. The findings suggest that the political-economic context and government policies have a greater influence on promoting cooperation, thus yielding positive or negative results for integrated care practice.
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Affiliation(s)
- Yin Sun
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Xudong Zhang
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan Province, China.
| | - Yuehong Han
- School of Marxism, Kunming University of Science and Technology, Kunming, Yunnan Province, China
| | - Bo Yu
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan Province, China.,School of Humanities and Management, Yunnan University of Chinese Medicine, Kunming, Yunnan Province, China
| | - Haidan Liu
- Faculty of Management and Economics, Kunming University of Science and Technology, Kunming, Yunnan Province, China
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Cloin M, Mathijssen J, Blaauw E. When opinions differ: the development of a reflection tool for youth professionals to support shared decision-making with parents. EUROPEAN JOURNAL OF SOCIAL WORK 2022; 26:389-400. [PMID: 37006454 PMCID: PMC10061805 DOI: 10.1080/13691457.2022.2040436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The importance of shared decision-making (SDM) in youth care is increasingly emphasised. Professional reflection on the decision-making process is an important means to improve the use of SDM in practice. In this study, we report on the development of a reflection tool for youth professionals primarily to use when they hold a different opinion then parents about referral to specialised youth care services. In co-creation with local youth professionals and parent representatives from the South of the Netherlands, the tool was developed and tested in practice. This process was guided by a three-stage cyclical research project. First, reflective group discussions provided an initial understanding of professionals' needs, interests and experiences. This input then was analysed and documented into a draft tool with reflective questions. Next, this tool was tested on fictive and real life cases and adjusted with input from youth professionals and parents. This process resulted in an online reflection tool covering 16 overarching reflective questions to support youth professionals' reflection on their shared decision-making in practice. The tool can be used and adapted by others in the field of youth care to improve the process of making shared decisions with parents in complex cases.
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Affiliation(s)
| | | | - Eva Blaauw
- Avans University of Applied Science, BredaNetherlands
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Garattini L, Badinella Martini M, Nobili A. Integrated care in Western Europe: a wise solution for the future? Expert Rev Pharmacoecon Outcomes Res 2022; 22:717-721. [PMID: 35196951 DOI: 10.1080/14737167.2022.2046465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION IC is a term commonly adopted across the world underpinning a positive attitude against fragmentation of healthcare service provision. While the principles supporting IC are simple, their implementation is more controversial. AREAS COVERED The growing number of IC definitions is related to the increasing domains of applications, which reflect the increasing demand induced by aging multi-morbid patients. A comprehensive definition of IC should now include the coordination of health and social services useful to deliver continuous care across organizational boundaries. The recent debate on IC is largely influenced by the mismatch between the increasing burden of health and social needs for chronic conditions from the demand side, and the design of health-care systems still focused on acute care from the supply side. EXPERT OPINION The major reasons of persisting IC weakness in European countries stem from arguable choices of health policy taken in the recent past. The political creed in 'market competition' is probably the most emblematic. All initiatives encouraging health-care providers to compete with each other are likely to discourage IC. Since most European GPs are still self-employed professionals working in their own cabinets, the anachronistic professional status of GPs is another historically rooted reason of IC weakness.
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Affiliation(s)
- Livio Garattini
- Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
| | | | - Alessandro Nobili
- Institute for Pharmacological Research Mario Negri IRCCS, Milan, Italy
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Pouls KP, Koks-Leensen MC, Mastebroek M, Leusink GL, Assendelft WJ. Adults with intellectual disabilities and mental health disorders in primary care: a scoping review. Br J Gen Pract 2022; 72:e168-e178. [PMID: 34903519 PMCID: PMC8884443 DOI: 10.3399/bjgp.2021.0164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/02/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND GPs are increasingly confronted with patients with both intellectual disabilities (ID) and mental health disorders (MHD). Currently, the care provided to these patients is found to be insufficient, putting them at risk of developing more severe MHD. Improving the quality of GP care will improve the whole of mental health care for this patient group. Therefore, an overview of the content and quality of care provided to them by the GP may be helpful. AIM To provide an up-to-date literature overview of the care provided by GPs to patients with ID and MHD, identify knowledge gaps, and inform research, practice, and policy about opportunities to improve care. DESIGN AND SETTING Scoping review. METHOD PubMed, PsycINFO, EMBASE, and grey literature were searched for publications concerning primary care and patients with ID and MHD. Selected publications were analysed qualitatively. RESULTS One hundred publications met the inclusion criteria. Five overarching themes were identified: GP roles, knowledge and experience, caregiver roles, collaboration, and a standardised approach. The results show GPs' vital, diverse, and demanding roles in caring for patients with both ID and MHD. GPs experience problems in fulfilling their roles, and gaps are identified regarding effective GP training programmes, applicable guidelines and tools, optimal collaborative mental health care, and corresponding payment models. CONCLUSION The improvement required in the current quality of GP care to patients with ID and MHD can be achieved by bridging the identified gaps and initiating close collaborations between care professionals, policymakers, and organisational managers.
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Affiliation(s)
- Katrien Pm Pouls
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Monique Cj Koks-Leensen
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mathilde Mastebroek
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Geraline L Leusink
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Willem Jj Assendelft
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
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While A. Can integrated care deliver? Br J Community Nurs 2022; 27:48-49. [PMID: 34990273 DOI: 10.12968/bjcn.2022.27.1.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alison While
- Emeritus Professor of Community Nursing, Florence Nightingale Faculty of Nursing, King's College London and Midwifery and Fellow of the QNI
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