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1 – 10 of 13J. Billings, A. Alaszewski and K. Coxon
This paper provides a European overview of alternative approaches to integrated care for older people, drawing from a wider European project entitled PROCARE. It discusses the…
Abstract
This paper provides a European overview of alternative approaches to integrated care for older people, drawing from a wider European project entitled PROCARE. It discusses the structural complexities that create the challenges in integrated care, compares and contrasts approaches to integrated care through a structure and process framework, and considers the place of person‐centred seamless care in European health and social care models.
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This paper presents a comparison of the views of staff working in 18 integrated care settings, undertaken as part of the PROCARE study of integrated health and social care. The…
Abstract
This paper presents a comparison of the views of staff working in 18 integrated care settings, undertaken as part of the PROCARE study of integrated health and social care. The data reveals some apparent commonalities across the nine European countries. Increased job satisfaction was an advantage of integrated working, but respondents also reported difficulties in working with hospitals or medical professionals, and continued barriers to integrated working generally. Overall, single standalone organisations such as home care teams reported the clearest benefits from integrated working, while cross‐agency models continued to encounter significant barriers to health and social care integration.
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It is suggested that a common understanding of integrated care between multi‐professional staff is vital to prevent barriers to unification and quality of care. This paper…
Abstract
It is suggested that a common understanding of integrated care between multi‐professional staff is vital to prevent barriers to unification and quality of care. This paper examines qualitative data from PROCARE, a recently completed European project on integrated care for older people, to put forward an interpretation of what integrated care means to staff. Through thematic analysis, four main clusters were identified. The paper suggests that, while the analysis revealed a common and inter‐related European interpretation that was somewhat idealised and moralistic, this was countered by challenges to its implementation that were inseparable from the rhetoric. The paper suggests that a collective, morally strong understanding is unable to prevent barriers to integrated care, and that tensions between services remain a prominent impediment.
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The aim of this chapter was to analyze of the most hazardous aspects of home care work in Italy.
Abstract
Purpose
The aim of this chapter was to analyze of the most hazardous aspects of home care work in Italy.
Methodology/Approach
The chapter is based on a multi-method analysis conducted in Italy, including a survey on a sample of 867 home care assistants, and four focus groups organized with home care assistants.
Findings
The data collected show that: (1) there is a strong correlation between the physical and emotional complexity of the work and the workers’ malaise; (2) the live-in formula is not clearly linked with high levels of psychophysical malaise, while isolation is associated much more strongly with a high index of malaise; and (3) violence in the workplace is clearly one of the main risks to which home care assistants are exposed.
Research Limitations/Implications
The findings may suffer from limitations due to the type of data collected. First, it was a convenience survey, so the results are not generalizable and they may be negatively influenced by bias relating to sample self-selection. Second, the empirical research was not designed to investigate occupational health alone, so accurate information on symptoms, causes of ill-health, experiences of violence, and the meaning of respondents’ malaise and of the episodes of violence were not available. Third, with the help of an epidemiologist, we could have included some diagnostic tests to better ascertain the workers’ state of health.
Originality/Value of Paper
The chapter offers an original contribution to sociological research on the occupational health hazards from a gender-specific perspective. First, it investigates workers’ health risks in an understudied and highly feminized and racialized occupational sector. It also analyzes the implications of both the emotional and the body work on the workers’ health. It deals with the correlation between cohabitation and health problems. Finally, it looks into the impact of workplace violence on workers’ health, which is a strongly gendered issue, and rooted in social processes that stigmatize and racialize migrant women employed as home care assistants.
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This paper reviews, rethinks, expands and applies the author's ‘laws’ of integration, which were first published six years ago. This approach both introduces the laws to readers…
Abstract
This paper reviews, rethinks, expands and applies the author's ‘laws’ of integration, which were first published six years ago. This approach both introduces the laws to readers who don't know them, and tests their utility for those who do. In retrospect, real‐world integration efforts mix and match the original components of linkage, co‐ordination and full integration. But the message remains to work at all levels, keep it simple, make finances supportive and empower social care.
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Eunhwa Yang, Yujin Kim and Sungil Hong
This study aims to understand how knowledge workers working from home during COVID-19 changed their views on physical work environments and working-from-home practices.
Abstract
Purpose
This study aims to understand how knowledge workers working from home during COVID-19 changed their views on physical work environments and working-from-home practices.
Design/methodology/approach
This study conducted a survey targeting workers in the USA recruited via Amazon Mechanical Turk. A total of 1,651 responses were collected and 648 responses were used for the analysis.
Findings
The perceived work-life balance improved during the pandemic compared to before, while the balance of physical boundaries between the workplace and home decreased. Workplace flexibility, environmental conditions of home offices and organizational supports are positively associated with productivity, satisfaction with working from home and work-life balance during the pandemic.
Research limitations/implications
While the strict traditional view of “showing” up in the office from Monday through Friday is likely on the decline, the hybrid workplace with flexibility can be introduced as some activities are not significantly affected by the work location, either at home-based or corporate offices. The results of this study also highlight the importance of organizations to support productivity and satisfaction in the corporate office as well as home. With the industry collaboration, future research of relatively large sample sizes and study sites, investigating workers’ needs and adapted patterns of use in home-based and corporate offices, will help corporate real estate managers make decisions and provide some level of standardization of spatial efficiency and configurations of corporate offices as well as essential supports for home offices.
Originality/value
The pandemic-enforced working-from-home practices awaken the interdependence between corporate and home environments, how works are done and consequently, the role of the physical workplace. This study built a more in-depth understanding of how workers who were able to continue working from home during COVID-19 changed or not changed their views on physical work environments and working-from-home practices.
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There is a strong tradition of integration in rural community hospitals which has been largely unrecognised in the past. The national strategy for health in England now gives…
Abstract
There is a strong tradition of integration in rural community hospitals which has been largely unrecognised in the past. The national strategy for health in England now gives community hospitals a central role in providing integrated health and social care, in a policy referred to as ‘care closer to home’. The evidence emerging from international and national studies is demonstrating the benefit of the community hospital model of care. Public support for community hospitals over their 100‐year history has been strong, with value being placed on accessibility, quality and continuity. There is, however, a tension between the national policy and the current financial pressures to close or reduce services in one in three community hospitals in England. Innovative ways of owning and managing these services are being put forward by communities who are actively seeking to maintain and develop their local hospitals. The challenge is to demonstrate that community hospital services are valued models of person‐centred integrated care, and to demonstrate their contribution to the health and well‐being of their communities.
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Jacqueline Cumming, Phoebe Dunn, Lesley Middleton and Claire O’Loughlin
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).
Abstract
Purpose
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).
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Originality/value
This paper is one of the first to explore the HCH model of care in NZ.
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This review aims to focus on the role of evidence in informing policy and practice in health and social care integration.
Abstract
Purpose
This review aims to focus on the role of evidence in informing policy and practice in health and social care integration.
Design/methodology/approach
Following discussion of the importance of defining the terms that are being used, the review addresses UK policy and practice developments in respect of integrated health and social care over the last two decades. It explores the extent to which these accord with the available evidence on effective strategies.
Findings
The review demonstrates that the focus in delivering integrated care should be on the local systems and cultures that can deliver positive outcomes for individuals. Structural change will not guarantee integrated care and diverts from the detail of local implementation that needs to be achieved. Current developments in both Scotland and England have some promise of delivering enduring progress.
Originality/value
The review provides a synthesis of key bodies of evidence and allows comparison between different polities within the UK.
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