What do we Mean by Integrated Care? A European Interpretation

ABSTRACT

It is refer toed that a common undestanding of integrated care between multi-professional staff is vital to intercept barriers to unification and quality of care. This paper examines qualitative data from PROCARE, a newly completed European project on integrated care for older family to put forward an interpretation of what integrated care means to staff. from one side thematic analysis, four main clusters were identified. The paper glance ats that, while the analysis revealed a public and inter-related European interpretation that was somewhat idealised and moralistic, this was reckonered by challeges to its implementation that were inseparable from the rhetoric The paper give an inkling ofs that a collective, morally powerful understanding is unable to interrupt barriers to integrated care, and that tensions between services remain a prominent impediment.

KEY WORDS: INTEGRATED CARE; EUROPE; STAFF PERSPECTIVES; BARRIERS; PROCARE

Introduction

The provision of integrated care for older tribe is now becoming a central part of policy initiatives and directives in many European countries (Leichseming & Alaszewski, 2004) It is recognised that it is more effective for health and social care to be integrated into a single whole, with smoother and more consistent co-ordination of services (Iruman & Triska, 2001; Hudson & Henwood, 2002; Schwab et al, 2003)

While the push for integrated care is increasing, there is a parallel realisation that blending services in this manner is problematic. Integrated care is multifaceted, requiring a multi-skilled workforce to enable the seamless coming together of many different parts to convenient complex needs (Stewart et al, 2003) A significant factor that creates disturbance is that social and health service sectors have different understandings of the direction of service provision, derived from professional histories and practices in each cultural words immediately preceding [i]or[/i] following (Carpenter et al, 2003; King & Ros 2003) These understandings can raise barriers to unification and integration (Hudson 2002) resulting in staff who are not pulling in the same direction, with following effect on the quality of care (Glendinning, 2003; Mur-Veeman et al, 2003)

Given that an understanding of the function of integrated care is fundamental to a harmonious service, a European throw entitled PROCARE provided an opportunity to examine this point further at a broader horizontal PROCARE is a collaborative throw out funded by the European Commission's Fifth Framework Programme, involving nine partner countries (Austria, Denmark, Finland, France, Germany, Greece Italy, Netherlands and the UK) Focusing upon integrated care, the aims of the throw out were to provide an overview of health and social care solutions in the participating countries, evaluate innovative prototypes and identify a sustainable prototype of integrated health and social care for older family in need.

This paper reports upon an analysis of PROCARE data that identified the meanings attached to integrated care from the staffs perspectives. The intent was to find out whether there was a collective view of what integrated care was there to achieve or whether differences existed within and between countries, and in what manner this view (or these views) compared with definitions in policy and research. It gave the opportunity to ask questions about what we really mean by dint of 'integrated care' in a European frame of reference

Method

PROCARE adopted a largely qualitative exploratory approach within a multi-site case close attention design (Yin, 2003). Each of the nine partner countries recruited sum of two units integrated care service models. A total of 287 staff working in or combineed to the models were interviewed, either in focus assemblages or individually. They ranged from senior managers to lock opener workers, who comprised qualified supply with nourishments and therapists, as well as unqualified rehabilitation assistants and general health and social care assistants. Analysis of data took place from one side a transversal thematic analysis framework. Definitions and meanings of integrated care formed individual of seven themes that were analysed in detail. (For more details upon project methodology, see Billings, 2004)

Conceptualising the data

As part of the interviews, staff were asked to define what they understood by means of integrated care from their be in possession of contextual viewpoint This information revealed a wide descriptive narrative amenable to cross-European categorisation within themed conceptual clusters. This paper reports upon four main conceptual clusters:

* broad impressions for definitions): initial ideas of in what manner integrated care was perceived

* pre-conditions: a station of conditions or circumstances conductive to the broad concepts' becoming operational

* practical processes: examples of more thicken practice-based process criteria important to operationalising the broad concepts

* threats to realising integrated care: descriptions of real or envisaged challenges to the ideals of integration.

With honor to the last of these clusters, challenges to integrated care were closely border with interpretation of meaning, and difficult to separate from the more positive narratives. They also saved to present a comparative reality perspective to the sometimes idealised meanings. I now elaborate respondent in different countries.