Integrated CareWhat do we stand to gain?

Kim Sutherland, PhD

Director, System and Thematic Reports

22 November 2014

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In brief

• What is integrated care?

• What do we stand to gain?

• What do we know?

– Perspectives

– Measurement

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Primary, secondary, tertiary and quarternary care

Patient-centred

Partnerships

Collaboration

ResponsivenessContinuity

Coordination

Seamless

Mental and physical health

Multidisciplinary

Tailored

Linking

Within, across, between teams

Right care, right place, right time

Hospitals and communities

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NSW Health Integrated Care Strategy 2014-2017

Integrated care involves the provision of seamless, effective and efficient care that responds to all of a person’s health needs, across physical and mental health, in partnership with the individual, their carers and family.

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Benefits of integrated care

• Better patient experiences

• Improved outcomes

• Improved adherence to treatment

• Improved quality of life

• Improved efficiency

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Poorly integrated care associated with:

• Duplication of services and infrastructure

• Under- and over-use of resources

• Medical errors and adverse events

• Accessibility problems

• Discontinuity in care

• Unmet healthcare needs

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Perspectives of integrated care

• System

• Organisations

• Teams

• Patients

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Measuring integrated care

• Effects of integrated care are wide-ranging

– Accessibility

– Appropriateness

– Effectiveness

– Efficiency

– Equity

– Sustainability

• Timescales vary

• Outcomes, processes, structures

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Why ask the patient?

• Patients as witnesses of, and as participants in, integration

• Patients are sometimes the only connection betweenproviders / sectors / specialties

• Baseline for measuring change over time

• Patients’ experiences relate to many, but not all, aspects ofintegrated care

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International framework for measuring integrated care

• Coordinated within care team

• Coordinated across care teams

• Coordinated between care teams and community resources

• Continuous familiarity with patient over time

• Continuous proactive and responsive action between visits

• Patient-centred

• Shared responsibility

(Singer et al, Medical Care Research and Review, 2011)

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Questions

or

comments?

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Equity:health for all, healthcare that’s fair

Resources, structures and organisation

Healthcare services

Produ

ctivi

ty

Patient needs and

expectations

Impa

ct

Patient outcomes

Sustainability:caring for the

futureEco

nom

ic co

ntex

t

Social context

Political context

Tech

nolog

ical c

onte

xt

Our framework to measure performance