Search results
1 – 10 of over 10000This research paper aimed to study the legal structure of top-performing health governance systems and compare them with the Indonesian health social security system to identify…
Abstract
Purpose
This research paper aimed to study the legal structure of top-performing health governance systems and compare them with the Indonesian health social security system to identify the main differences and provide recommendations for Indonesian and other developing countries’ health policymakers and administrators.
Design/methodology/approach
Using formative research with a conceptual approach and statute approach as method in this study. Data was gathered using the document study technique, which studies various documents, especially legal documents related to health law, linked to legal purpose theories. Moreover, the World Health Organization ranking was considered to choose the two countries (France and Singapore) with a high social health security system for comparative analysis. All data collected has been analyzed using a qualitative and theoretical basis. Content analysis was performed by analyzing the legal documents, and the regulatory framework of all three countries was deeply analyzed to draw conclusions and recommendations.
Findings
Indonesia has specific laws to implement a social security system in the health sector. However, the lack of the best medical facilities and infrastructure and weak implementation of existing laws were identified as major reasons behind the poor health security system compared to comparative countries. Also, as a developing nation Indonesian Government face budgetary pressures and huge population challenges to meet required standards. Thus, the financing approaches used by Singapore and France may help developing countries meet these challenges effectively. Therefore, there is a dire need to strengthen the social health security system all over the country with amendments to laws and ensure the implementation of prevailing laws and regulations.
Practical implications
Providing understanding related to the social security health system in Indonesia along with a detailed description of the sound social health security system in France and Singapore will further provide an avenue for the researchers to critically analyze this line of study to devise some valuable suggestions further and to draw loopholes in the system.
Originality/value
A comparative approach for legal studies in the health sector is rare. So, this research advanced the social security health system-related literature and legal studies on the health sector by using this comparative approach to develop policy insights and future research directions, which will further help the field to grow.
Details
Keywords
Samuli Tikkanen, Pekka Räsänen, Timo Sinervo, Ilmo Keskimäki, Merja Sahlström, Tiina Pesonen and Hanna Tiirinki
Health care integration is crucial in improving service equality and patient outcomes. However, measuring integration between the health and social care sectors remains…
Abstract
Purpose
Health care integration is crucial in improving service equality and patient outcomes. However, measuring integration between the health and social care sectors remains challenging. This article aims to review existing systematic models to identify alternative health and social care integration measurement tools. The review focuses on models that involve systematic planning and long-term cooperation across different organizational sectors.
Design/methodology/approach
The study examines various dimensions and elements of integration, including process, outcome and structural measures. It compares different tools used to measure social and health care integration, such as the Rainbow model, Balanced Scorecard (BSC) Scorecard, PRISMA, SCIROCCO, integRATE, health-data simulation (HSIM) and the model developed by Åhgren and Axelsson. The analysis includes both empirical studies and theoretical frameworks.
Findings
The findings highlight the importance of standardized measurement methods to assess the impact of integration initiatives on patient outcomes, healthcare costs and the quality of care.
Originality/value
The review contributes to the ongoing discourse on social and health care integration, particularly in the Nordic context. The results can inform social and healthcare providers, policymakers and researchers in evaluating and improving integration initiatives.
Details
Keywords
Tuomas Hujala and Harri Laihonen
This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform…
Abstract
Purpose
This article analyses a major healthcare and social welfare reform establishing new regional and integrated wellbeing services counties in Finland. The authors approach the reform and service integration as a knowledge management (KM) issue and analyse how KM appears and contributes in the context of integrated care, specifically in the process of integrating social and health care.
Design/methodology/approach
The article analyses the case organisation's KM initiatives in light of the integrated care literature and recognises the tasks and requirements for effective KM when building integrated health and social care system. The empirical research material for this qualitative study consisted of the case organisation's strategy documents, the results of an external maturity assessment, KM workshop materials and publicly available documentation of the Finnish health and social care reform.
Findings
This study identifies the mechanisms by which KM can support health and social services integration. At the macro level, national coordination and regional co-operation require common information structures. At the meso level, a shared regional strategy with shared objectives guides both organisational decision-making and collaboration between professionals. At the micro level, technology supported and data-driven planning of service chains complements the experiences of professionals and may help remove obstacles to integration.
Originality/value
This study contributes to the literature on integrated care by providing a more comprehensive view of the role and tasks of knowledge and KM when reforming health and social services than approaches focussing solely on health informatics and internal efficiency.
Details
Keywords
Gabriela Uribe, Ferdinand Mukumbang, Corey Moore, Tabitha Jones, Susan Woolfenden, Katarina Ostojic, Paul Haber, John Eastwood, James Gillespie and Carmen Huckel Schneider
Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is…
Abstract
Purpose
Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.
Design/methodology/approach
A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.
Findings
In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.
Originality/value
The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.
Details
Keywords
Annie Williams, Hannah Bayfield, Martin Elliott, Jennifer Lyttleton-Smith, Honor Young, Rhiannon Evans and Sara Long
Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject…
Abstract
Purpose
Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject to secure accommodation orders between 1st April 2016 and 31st March 2018.
Design/methodology/approach
Children in the UK aged 10–17 years who are deemed to be at a significant level of risk to themselves or others may be subject to a secure accommodation order, leading to time spent in a secure children’s home (SCH) on welfare grounds. Following a rise in the number of children in Wales referred to SCHs for welfare reasons, this paper describes these young people’s journeys into, through and out of SCHs, giving insight into their experiences and highlighting areas for policy and practice improvements.
Findings
Findings indicate that improvements in mental health support and placement availability are key in improving the experiences of this particularly vulnerable group of young people throughout their childhood.
Practical implications
Other practical implications of the study’s findings, such as improvements in secure transport arrangements, are also discussed.
Originality/value
While the findings are limited by the reliance on self-report methods and the size of the study, namely, the small number of young people with experience of SCHs who were able to participate, the findings build on the existing knowledge base around children’s residential accommodation and provide new insights into how best to support these children.
Details
Keywords
Jeanette Prorok, Kelly Kay, Adam Morrison and Salinda Anne Horgan
Performance measures are an important mediating mechanism that influences the design and delivery of care. Unfortunately, it is still commonly the case that acute care indicators…
Abstract
Purpose
Performance measures are an important mediating mechanism that influences the design and delivery of care. Unfortunately, it is still commonly the case that acute care indicators are employed to assess the efficacy of integrated care. This hinders the ability to accurately assess and continuously improve integrated care efforts for priority populations, including older persons who live with complex health and social care requirements. A core set of indicators is needed from which to assess the quality and impact of integrated care on these older persons and care partners.
Design/methodology/approach
A modified Delphi process was employed that comprised of the following steps: (1) selection of an indicator inventory (2) defining criteria for ranking and achieving consensus, (3) recruiting participants, (4) iterative voting rounds and analysis and (5) selection of a core indicator set.
Findings
The study produced a core set of 16 indicators of integrated care that pertain to older persons who live with health and social care requirements. The set can be applied by health and social care organizations and systems to assess the quality and impact of integrated care for this population across the continuum of care.
Research limitations/implications
Although the gap in the availability of relevant indicators was the impetus for the study, this also meant there was a dearth of validated indicators to draw from. There are significant gaps in commonly used data sets with respect to indicators of integrated care as it relates to older persons and care partner.
Practical implications
The indicator set is intended to follow the older person and care partner throughout their health journey, enabling a whole systems view of their care. The set can be used in full or in part by health and social care systems and organizations across various primary, acute, rehabilitative and community settings for program development and evaluation purposes.
Social implications
The core set of indicators that emerged out of this study is a first step toward ensuring that older persons who live with complex health and social care requirements and their care partners receive quality integrated care across the continuum of care.
Originality/value
The findings are informed by the perspectives of older persons, care partners and healthcare professionals. Future research is needed to test, validate and potentially expand the indicator set.
Details
Keywords
Siu Mee Cheng and Cristina Catallo
The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address…
Abstract
Purpose
The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address the social isolation and health needs of a highly vulnerable older adult population living in the north Toronto communities. These are Russian-speaking Jewish older adult immigrants. The case provides a detailed description of the factors that enabled a diverse group of health and social care organizations to integrate their respective services to address the health and social care needs of their clients using a culturally appropriate and trauma-informed lens.
Design/methodology/approach
A case description comprised of key informant interviews, and a focus group was undertaken of representatives from health and social care organizations serving clients in the north Toronto area.
Findings
This case description identified eleven integration factors that enabled organizations to provide integrated care using a culturally appropriate and trauma-informed lens, and they include developing an aligned vision and goals, communications, an inter-organization culture of inter-dependence, champions, pre-existing relationships, and champions. In addition, operating in the not-for-profit sector, sector differences, enabling public policies and a strong sense of community have influenced integration of services across the organizational partners to serve its high-risk client group.
Originality/value
This case description lends insights into how IHSC can be leveraged to provide culturally appropriate and trauma-informed care for highly vulnerable client/patient populations. A lesson learnt is that social care partners can engage in successful integration leadership in joint health and social care integration efforts.
Details
Keywords
At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…
Abstract
At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.
Details
Keywords
The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health…
Abstract
Purpose
The purpose of this research is to identify novel ways of tackling health inequalities of underserved populations. It explores the opportunities presented by the changes in health and social care legislation to employ historically underused services, such as police custody healthcare providers, in addressing health inequalities.
Design/methodology/approach
This research analyses the policy approaches to tackling health inequalities in the UK in the past 40 years with an emphasis on those experienced by the people detained in English police custodies. It analyses the current model of healthcare in police custody and proposes a novel integrated model of care and joint commissioning opportunities in funding it.
Findings
Policies to tackle health inequalities have largely failed, as they became entrenched. But recent changes in the health and social care legislation in England offer opportunities to address them by employing historically underused healthcare services, such as those operating in police custodies.
Research limitations/implications
The research does not touch upon ethical considerations related to the patient privacy aspect of integrated care. Interventions by and interactions with police custody healthcare providers would be visible to all professionals with access to the patient’s health record. As with all novel interventions or innovative models of care, the effectiveness of such clinical interventions remains to be established by further research. It opens a new line of research on quality improvement through integration of care and explores understudied aspects of joint commissioning of integrated care.
Practical implications
It offers health commissioners and public health leaders the opportunity to employ police custody healthcare services in reaching their population health management objectives and meeting their health inequalities objectives at local level. It also gives police and crime commissioners the opportunity to address the health drivers of criminal behaviour that overlap with health inequalities. It offers funding opportunities presented by jointly commissioning services at lower costs to both police and health commissioners alike. It improves the health outcomes of historically underserved populations by facilitating access to health and social care services and facilities.
Social implications
Reducing health inequalities and disparities in health outcomes can decrease the costs of the healthcare services over the long term and might contribute to reducing criminality by addressing inequities and some health drivers of criminal behaviour.
Originality/value
The paper explores understudied opportunities offered by the recent changes in health and social care legislation in England and includes underused resources to tackle health inequalities.
Details