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Open Access
Book part
Publication date: 6 May 2019

Denise Alexander, Uttara Kurup, Arjun Menon, Michael Mahgerefteh, Austin Warters, Michael Rigby and Mitch Blair

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health…

Abstract

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

Open Access
Article
Publication date: 1 September 2023

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

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 14 March 2023

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…

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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

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 16 November 2022

Qingqing ZONG, Yi ZHANG and Yuyu CHEN

This paper theoretically and empirically analyzes the effects of the elderly’s physical health status on their need for care and the choice of care models in China.

Abstract

Purpose

This paper theoretically and empirically analyzes the effects of the elderly’s physical health status on their need for care and the choice of care models in China.

Design/methodology/approach

Empirically, the estimation results of a large-sample randomized intervention trial with chronic obstructive pulmonary disease (COPD) patients through the difference-in-difference method indicated the following: (1) After the COPD intervention trial, the physical health status of the elderly in the treatment group improved significantly, the need for care was substantially reduced and the health improvement led to a 35.5% reduction in the probability of using elderly care. (2) The reduction in the need for care regarding the treatment group occurred mainly in social care. The probability of using social care decreased by 67.8% due to the elderly’s health improvement, while that of home care remained unchanged generally. (3) Further heterogeneity tests suggested that families with fewer potential internal resources for caregiving had a more pronounced decline in the need for social care.

Findings

Theoretically, these empirical results support the existence of the “pecking order” theory in the family’s choice of elderly care model, that is, families tend to employ all internal resources for caregiving before resorting to social care, resulting in a higher sensitivity of social care to health.

Originality/value

The main policy implication of this paper is that ex ante preventive health intervention policies can significantly alleviate the burden of care, especially social care, on families. And preventive health intervention policies are particularly effective in reducing the burden of the families with relatively few resources for informal internal care.

Details

China Political Economy, vol. 5 no. 2
Type: Research Article
ISSN: 2516-1652

Keywords

Open Access
Article
Publication date: 29 September 2021

Tuomas Hujala and Harri Laihonen

The purpose of this study is twofold. First, it suggests that knowledge management (KM), as an academic discipline and managerial practice, provides valuable perspectives and…

6130

Abstract

Purpose

The purpose of this study is twofold. First, it suggests that knowledge management (KM), as an academic discipline and managerial practice, provides valuable perspectives and tools to help health and social care management cope with both existing and future challenges. Second, it reviews the existing evidence on the effects of KM on the management of health and social care. Based on the results of the review, an evaluation framework for the effects of KM is proposed.

Design/methodology/approach

The literature review was conducted using the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to search the Web of Science and SCOPUS databases. The search terms included “knowledge management”, “healthcare” and “effect.” Academic articles published between 2010 and 2020 were included.

Findings

The study identifies six main categories among the effects of KM on the management of health and social care as follows: enhanced understanding of customer needs, improved organizational performance, better targeted decision-making, improved quality of service, behavioral or cultural change and improved risk management.

Originality/value

This study contributes by summarizing the literature on the effects of KM on the management of health and social care and proposing avenues for future research in this area.

Details

Journal of Knowledge Management, vol. 25 no. 11
Type: Research Article
ISSN: 1367-3270

Keywords

Open Access
Article
Publication date: 2 January 2023

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…

1998

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

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 8 April 2022

Cemil Eren Fırtın

This study aims to explore the calculations and valuations that unfold in everyday practices within social care settings. Specifically, the paper concerns the role of accounting…

1272

Abstract

Purpose

This study aims to explore the calculations and valuations that unfold in everyday practices within social care settings. Specifically, the paper concerns the role of accounting in dealing with multiple calculable and non-calculable spaces within the case management process. The study sheds light on the multiplicity produced in constructing the client as an object through the calculations and valuations embedded in the costing and caring practices in social work.

Design/methodology/approach

This is a qualitative case study in a Swedish social care organisation, with a specific focus on the calculations and valuations within the case management process. The data have been gathered from 20 interviews with social workers, team leaders, managers and a management accountant, along with more than 36 h of on-site observations and internal organisational documents, including policy documents, guidelines and procedural lists.

Findings

The case management process involves interconnected practices in constructing the client as an object. While monetary calculations and those associated with worth are embedded in costing and caring practices, they interact and proliferate in various ways. Three elements are found: transforming service units into centres of calculation, constructing the accounts of calculation and establishing the cost-value calculations. Calculations and valuations are actuated in these elements in describing the need, matching the case with the unit and caseworker and deciding on the measure. The objectification of the client entails the construction of accounts, for example, ongoing qualifications, categorisations and groupings of units, juridical frameworks, case types, needs and measures. As an object multiple, the client becomes different objects at different stages, challenging the establishment accounts, and thus producing a range of calculations and valuations. Such diversity in calculations concomitantly produces more calculations to represent the present and absent multiple facets of the client, resulting in a multiplicity of costing and caring.

Practical implications

The study might flag up for practitioners the possible risks and unintended consequences of depending too much on fixed guidelines and (performance) indicators since social work involves object multiples, which are always in diversity and changeable in situ. Considering the multiple dimensions within the specific contexts could thus be helpful to mitigate such risks in the evaluation of social care processes and the design of (performance) metrics.

Originality/value

This study contributes to the literature on accountingisation by extending the concept as a part of ongoing organisational practices, materialised within the calculations of money and worth in everyday social care. Besides demonstrating their reconsolidation, this study shows a multiplicity of costing and caring practices depending on the way the client is constructed, resulting in the proliferation of accounting(s) and ultimately accountingisation of social work.

Details

Qualitative Research in Accounting & Management, vol. 20 no. 1
Type: Research Article
ISSN: 1176-6093

Keywords

Open Access
Article
Publication date: 6 March 2024

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

Journal of Children's Services, vol. 19 no. 1
Type: Research Article
ISSN: 1746-6660

Keywords

Open Access
Article
Publication date: 28 March 2023

Nicola Capolupo, Zuzana Virglerová and Paola Adinolfi

This paper explores total quality management (TQM) soft domain efficacy in social care organizations to determine the extent to which an organization's project success may stem…

Abstract

Purpose

This paper explores total quality management (TQM) soft domain efficacy in social care organizations to determine the extent to which an organization's project success may stem from soft TQM critical success factors (CSFs).

Design/methodology/approach

Non-structured interviews were conducted with 16 managers overseeing the prosthetic device regeneration project of the Italian local health unit (located in Salerno) to explore which soft factors could contribute to the success of a social care multifunctional organization.

Findings

Organizations' handling of certain projects, such as pivoting on soft TQM issues, may allow them to be configured as multiservice organizations. Therefore, a conceptual model of a multiservice social care organization is proposed.

Practical implications

From a managerial perspective, this study presents an interesting success case of a multiservice social care organization with a total annual expenditure of €20 million on prosthetic assistance. Preliminary data show a 13% reduction in public expenditure for Salerno's local health unit via a refurbishment project.

Originality/value

The paper contributes to the soft TQM literature debate: although Italian local health professionals appear aware of soft TQM issues' implementation and consciously apply them in their organization and projects, this occurs more with specific CSFs emerging from the literature. Therefore, this article paves the way for further quantitative and theoretical investigations on the adoption of TQM soft issues in social care organizations' performance measurement.

Open Access
Article
Publication date: 17 October 2022

Marta Piria, Mara Gorli and Giuseppe Scaratti

The study refers to a health-care organization engaged in adopting “home health care” as a new object of activity. This study aims to explore how the reconfiguration of the object…

Abstract

Purpose

The study refers to a health-care organization engaged in adopting “home health care” as a new object of activity. This study aims to explore how the reconfiguration of the object influences the transformative perspective, affecting not just a service but a broader approach and meaning behind patient care. It also investigates the main contradictions at play and the levers to support inter-organizational learning while facing the new challenges and change processes.

Design/methodology/approach

The work is based on a qualitative and ethnographic methodology directed to examine cultural, practical and socio-material aspects. The activity theory is assumed as a powerful approach to understand collective learning and distributed agency processes.

Findings

The renewal of the new object of work is analyzed as a trigger for shifts in representations, cultural processes and collective support implemented by the organization. Three agentic trajectories – technical, dialogical and collaborative agency – were cultivated by the management to deliver home health care through joint exercises of coordination and control, dialogical spaces and collaborative process.

Research limitations/implications

The data collection was disrupted by the pandemic. A follow-up study would be beneficial to inquire how the learning processes shifted or were influenced by the contextual changes.

Practical implications

This contribution provides a practical framework for health-care organizations aiming to navigate and explore the physiological tensions and contradictions emerging when the object of work is changed.

Originality/value

The paper develops the field of intra- and inter-organizational learning by presenting an intertwined and structural connection between these processes and the renewing of the object of work. It advises that processes of transformation must be handled with attention to the critical and collective dynamics that accompany sustainable and situated changes.

Details

Journal of Workplace Learning, vol. 35 no. 3
Type: Research Article
ISSN: 1366-5626

Keywords

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