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Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

Older people who reside in care homes have varying access and quality of medical care; in the UK, this is provided by general practitioners (GPs). The authors aimed to explore the experiences of trainee GPs in delivering integrated care and discuss, with senior GPs, opportunities to improve training.

Two trainees and thirteen senior GPs were recruited through professional networks and participated in semi-structured interviews. Transcriptions were analysed using thematic analysis, and the theory of negotiated order was used to interpret findings.

Trainees received no specific training on working with care homes. Exposure to the care home setting was variable, and could be negligible, depending on the GP practice placement. Senior GPs expressed concerns about patient safety, due to practical challenges of the consultation and a sense of lack of control. Considering the theory of negotiated order, where GPs had trusting relationships with care home staff, the input of the staff could mitigate the sense of risk. Care plans could communicate needs and preferences within the team and may be a way of extending the negotiated order, for example giving care homes authority to implement end-of-life care when the GP is not present.

The authors identified a need for trainees to engage with the organisational aspect of the care home to deliver integrated care. Trusted relationships with staff led to improved consultations, care plans, and better management of risk.

This is the first study of learning needs for GP trainees to provide integrated care for older care home residents.

The National Primary Care Development Team (NPDT) is spreading the Unique Care approach to case management across the country, and this article presents a case study of how Brent is successfully implementing Unique Care through the Care Co‐ordination Service. It aims to outline key steps in the development of the service, moving from the initial vision, to pilot phase and on to mainstreaming of the service. The collaborative methodology was adopted. The evidence suggests impressive reductions in service use, alongside an increase in quality of life and improved perception of health and social care services among older people who have had contact with the team.

The purpose of this paper is to report on the origins, development and early impacts of a Health Care Home (HCH) model of care being rolled out around New Zealand (NZ).

This paper draws on a literature review on HCHs and related developments in primary health care, background discussions with key players, and a review of significant HCH implementation documents.

The HCH model of care is emerging from the sector itself and is being tailored to local needs and to meet the needs of local practices. A key focus in NZ seems to be on business efficiency and ensuring sustainability of general practice – with the assumption that freeing up general practitioner time for complex patients will mean better care for those populations. HCH models of care differ around the world and NZ needs its own evidence to show the model’s effectiveness in achieving its goals.

It is still early days for the HCH model of care in NZ and the findings in this paper are based on limited evidence. Further evidence is needed to identify the model’s full impact over the next few years.

This paper is one of the first to explore the HCH model of care in NZ.

Changes in demographics and disease patterns are challenging health and care systems across the world. In England, national policies have reset the direction of travel for the NHS. Collaboration, integration and personalisation are intended to become prime principles and drivers for new models of care. Central to this is the concept of population health management. This has emerged, internationally, as a method to improve population health. Fundamental for population health management to succeed is the use of integrated data, analytics combined with professional insight and the adoption of a learning health system culture. This agenda reaches beyond the NHS in England and the public health profession to embrace a broad range of stakeholders. By drawing on international experience and early experience of implementation in the United Kingdom, the potential for health and care systems in England to become world leading in population health management is explored.

A viewpoint paper.

Population health management is a major change in the way health and care systems look at the challenges they are facing. It makes what is happening to individuals, across the continuum of care, the essence for insight and action. The NHS has the components for success and the potential to become world leading in delivery of population health management as part of its integrated care agenda.

This is the first viewpoint paper to set out how population health management contributes to the integrated care agenda in the NHS.

As the notion of “integrated care” has received ever greater policy traction, so the idea that a named individual should take responsibility for coordinating the various elements of care for service users has also gained ground. The purpose of this paper is to look at the proposal to hand this role to GPs, examine the policy expectations and explore some of the implementation dilemmas.

Review of policy documents and relevant literature.

That the role of “care coordinator” has rarely succeeded in the past and that there are specific difficulties in expecting GPs to take on the task.

Review of existing literature linked to emergent policy – no original research.

This is a new application of an enduring policy concept. Currently the literature is thin.

While there is established research that explores individual innovations across countries or developments in a specific health area, there is less work that attempts to match national innovations to specific systems of health governance to uncover themes across nations.

We used a cross-comparison design that employed content analysis of health governance models and innovation patterns in eight OECD nations (Australia, Britain, Canada, France, Germany, the Netherlands, Switzerland, and the United States).

Country-level model of health governance may impact the focus of health innovation within the eight jurisdictions studied. Innovation across all governance models has targeted consumer engagement in health systems, the integration of health services across the continuum of care, access to care in the community, and financial models that drive competition.

Improving our understanding of the linkage between health governance and innovation in health systems may heighten awareness of potential enablers and barriers to innovation success.

This paper aims to explore the content of Safeguarding Adult Reviews (SARs) from older adult care homes to understand how safety is understood and might be measured in practice.

SARs relevant to older adult care homes from 2015 onwards were identified via the Social Care Institute of Excellence SARs library. Using thematic analysis, initial inductive coding was mapped to a health-derived safety framework, the Safety Measurement and Monitoring Framework (SMMF).

The content of the SARs reflected the dimensions of the SMMF but gaining a deeper understanding of safety in older adult care homes requires additional understanding of how this unique context interacts with these dimensions to create and prevent risks and harms. This review identified the importance of external factors in care home safety.

This study provides an insight into the scope of safety issues within care homes using the SARs content, and in doing so improves understanding of how it might be measured. The measurement of safety in care homes needs to acknowledge that there are factors external to care homes that a home may have little knowledge of and no ability to control.

The aim of this paper is to analyze and measure the effects of intellectual capital (IC), i.e. human capital (HC), relational capital (RC) and structural capital (SC), on healthcare industry organizational performance and understanding the role of data analytics and big data (BD) in healthcare value creation (Wang et al., 2018). Through the assessment of determined variables specific for each component of IC, the paper identifies the guidelines and suggests propositions for a more efficient response in terms of services provided to citizens and, specifically, patients, as well as predicting effective strategies to improve the care management efficiency in terms of cost reduction.

The study has a twofold approach: in the first part, the authors operated a systematic review of the academic literature aiming to enquire the relationship between IC, big data analytics (BDA) and healthcare system, which were also the descriptors employed. In the second part, the authors built an econometric model analyzed through panel data analysis, studying the relationship between IC, namely human, relational and structural capital indicators, and the performance of healthcare system in terms of performance. The study has been conducted on a sample of 28 European countries, notwithstanding the belonging to specific international or supranational bodies, between 2011 and 2016.

The paper proposes a data-driven model that presents new approach to IC assessment, extendable to other economic sectors beyond healthcare. It shows the existence of a positive impact (turning into a mathematical inverse relationship) of the human, relational and structural capital on the performance indicator, while the physical assets (i.e. the available beds in hospitals on total population) positively mediates the relationship, turning into a negative impact of non-IC related inputs on healthcare performance. The result is relevant in terms of managerial implications, enhancing the opportunity to highlight the crucial role of IC in the healthcare sector.

The relationship between IC indicators and performance could be employed in other sectors, disseminating new approaches in academic research. Through the establishment of a relationship between IC factors and performance, the authors implemented an approach in which healthcare organizations are active participants in their economic and social value creation. This challenges the views of knowledge sharing deeply held inside organizations by creating “new value” developed through a more collaborative and permeated approach in terms of knowledge spillovers. A limitation is given by a fragmented policymaking process which carries out different results in each country.

The analysis provides interesting implications on multiple perspectives. The novelty of the study provides interesting implications for managers, practitioners and governmental bodies. A more efficient healthcare system could provide better results in terms of cost minimization and reduction of hospitalization period. Moreover, dissemination of new scientific knowledge and drivers of specialization enhances best practices sharing in the healthcare sector. On the other hand, an improvement in preventive medicine practices could help in reducing the overload of demand for curative treatments, on the perspective of sharply decreasing the avoidable deaths rate and improving societal standards.

The authors provide a new holistic framework on the relationship between IC, BDA and organizational performance in healthcare organizations through a systematic review approach and an empirical panel analysis at a multinational level, which is quite a novelty regarding the healthcare. There is little research focussed on healthcare industries' organizational performance, and, specifically, most of the research on IC in healthcare delivered results in terms of theoretical contribution and qualitative analyzes. The authors even contributed to analyze the healthcare industry in the light of the possible existence of synergies and networks among countries.