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Building integrated care systems: a case study of Bidasoa Integrated Health Organisation.

Polanco NT, Zabalegui IB, Irazusta IP, Solinís RN, Del Río Cámara M - Int J Integr Care (2015)

Bottom Line: Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items.Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients' perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

View Article: PubMed Central - HTML - PubMed

Affiliation: O+Berri, Basque Institute for Healthcare Innovation, Basque Country, Spain.

ABSTRACT

Introduction: This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011-2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions.

Methods: This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i) readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii) collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii) overall impact of integration through several indicators based on the Triple Aim Framework.

Results: The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients' perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.

Conclusion: There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

No MeSH data available.


Per capita cost in Bidasoa Integrated Health Organisation and budget allocation
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fg0009: Per capita cost in Bidasoa Integrated Health Organisation and budget allocation

Mentions: Reaching a good health status of the catchment population and providing them with a good experience of care should be complemented with an efficient approach in which per capita costs are reduced as much as possible without compromising health quality. In Bidasoa Integrated Health Organisation, there has been a decreasing trend in relation to costs since integration of both levels of care began as we can see onFigure 9. However, we could not directly attribute the drop in costs to integrated care [31] but to budget restrictions that are taking place in the Basque Country and all over Europe [32]. It should also be noticed that 573 Euros of per capita seems rather modest taking into consideration that the average per capita spending for health in Spain was 2199 Euros [33]. The reason for such a low figure is that the Hospital of Bidasoa does not provide tertiary care, which is the most expensive of all levels of care. Patients that need tertiary care are referred to the Hospital of Donostia, which belongs to another Integrated Health Organisation. Regarding budget allocation, we can appreciate modestly how primary care is gaining more power with respect to secondary care and it will be desirable to analyse if this trend continues over the following years.


Building integrated care systems: a case study of Bidasoa Integrated Health Organisation.

Polanco NT, Zabalegui IB, Irazusta IP, Solinís RN, Del Río Cámara M - Int J Integr Care (2015)

Per capita cost in Bidasoa Integrated Health Organisation and budget allocation
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4491322&req=5

fg0009: Per capita cost in Bidasoa Integrated Health Organisation and budget allocation
Mentions: Reaching a good health status of the catchment population and providing them with a good experience of care should be complemented with an efficient approach in which per capita costs are reduced as much as possible without compromising health quality. In Bidasoa Integrated Health Organisation, there has been a decreasing trend in relation to costs since integration of both levels of care began as we can see onFigure 9. However, we could not directly attribute the drop in costs to integrated care [31] but to budget restrictions that are taking place in the Basque Country and all over Europe [32]. It should also be noticed that 573 Euros of per capita seems rather modest taking into consideration that the average per capita spending for health in Spain was 2199 Euros [33]. The reason for such a low figure is that the Hospital of Bidasoa does not provide tertiary care, which is the most expensive of all levels of care. Patients that need tertiary care are referred to the Hospital of Donostia, which belongs to another Integrated Health Organisation. Regarding budget allocation, we can appreciate modestly how primary care is gaining more power with respect to secondary care and it will be desirable to analyse if this trend continues over the following years.

Bottom Line: Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items.Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients' perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

View Article: PubMed Central - HTML - PubMed

Affiliation: O+Berri, Basque Institute for Healthcare Innovation, Basque Country, Spain.

ABSTRACT

Introduction: This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011-2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions.

Methods: This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i) readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii) collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii) overall impact of integration through several indicators based on the Triple Aim Framework.

Results: The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients' perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.

Conclusion: There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

No MeSH data available.