In its latest Croakey update, the Primary Health Care Research & Information Service (better known as PHCRIS) reports on one of the biggest challenges facing health systems globally: the need to achieve integration at multiple levels. PHCRIS has published a series of five Policy Issue Reviews that examine integration at each level.
Petra Bywood writes
Health systems worldwide are plagued with similar challenges:
* ageing populations
* growing complexity in health conditions (for example, multimorbidities)
* rising demand for expensive technologies
* workforce pressures
* unsustainable healthcare costs.
Fragmented health care, including duplications and gaps in services, contributes to wasted resources and poor health outcomes for individuals and communities.
Universally, health reforms recognise that health systems with strong integrated primary health care at their core are both effective and efficient at delivering appropriate services where they are needed most. However, achieving integrated health care is a major challenge. It requires integration at multiple levels of a health system, including policies that enable organisations to support and provide leadership to the teams of health care providers that deliver care.
PHCRIS has prepared a series of five Policy Issue Reviews that examined integration across the macro level of systems and policies, the meso level of organisations and the micro level of service delivery. These reviews discuss vertical and horizontal integration in terms of the primary health care stakeholders that play a role in integrated care.
A discussion of macro level policies in Australia, including national, state/territory and shared policies that provide an overarching vision for integrated care and underpin governance, resources, funding and strategies to deliver integrated health care services.
A review of the macro level policies in other countries that address integration, with a view to informing integrated care policies in the Australian health system.
An exploration of the diverse organisations that operate at the meso level between policy (macro) and service delivery (micro) to build links between health service providers and between provider organisations. It considers relevant models and mechanisms for integrating care and identifies challenges and enablers to integration.
A qualitative research project that explores the understandings and principles of integration from the perspective of chief executive officers in the first tranche of Medicare Locals. The strengths, weaknesses, opportunities and threats to Medicare Locals as agents for integration are discussed.
A focus on the micro or service delivery level of health care. It identifies some of the key factors that influence service delivery, including the main barriers and enablers of integration. Australian and international examples of successful or promising initiatives that have been used to promote integration at the micro level are discussed.
This series of Policy Issue Reviews can be accessed on the PHCRIS website at www.phcris.org.au/policyreview/ and features in the 3 October 2013 edition of PHCRIS eBulletin, available at http://www.phcris.org.au/publications/ebulletin/index.php.
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