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Strengthening Integrated Care Through Population-Focused Primary Care Services: International Experiences Outside the United States
Annual Review of Public Health ( IF 20.8 ) Pub Date : 2017-04-06 00:00:00 , DOI: 10.1146/annurev-publhealth-031816-044518
Rene Loewenson 1 , Sarah Simpson 1
Affiliation  

Many high- and middle-income countries (HMICs) are experiencing a burden of comorbidity and chronic diseases. Together with increasing patient expectations, this burden is raising demand for population health–oriented innovation in health care. Using desk review and country case studies, we examine strategies applied in HMICs outside the United States to address these challenges, with a focus on and use of a new framework for analyzing primary care (PC). The article outlines how a population health approach has been supported by focusing assessment on and clustering services around social groups and multimorbidity, with support for community roles. It presents ways in which early first contact and continuity of PC, PC coordination of referral, multidisciplinary team approaches, investment in PC competencies, and specific payment and incentive models have all supported comprehensive approaches. These experiences locate PC as a site of innovation, where information technology and peer-to-peer learning networks support learning from practice.

中文翻译:


通过以人群为中心的初级保健服务加强综合护理:美国以外的国际经验

许多高收入和中等收入国家(HMIC)正在承受合并症和慢性病的负担。再加上患者期望值的提高,这种负担增加了对以人群健康为导向的医疗保健创新的需求。通过案头审查和国家案例研究,我们研究了在美国境外的HMIC中应用的策略,以应对这些挑战,重点是和使用了用于分析初级保健(PC)的新框架。本文概述了如何通过围绕社会群体和多发病率对服务进行评估和聚类,以及对社区角色的支持,来支持人口健康方法。它介绍了PC的早期首次接触和连续性,推荐人的PC协调,多学科团队方法,对PC能力的投资,特定的薪酬和激励模式都支持综合方法。这些经验使PC成为创新的场所,信息技术和点对点学习网络在此支持实践学习。

更新日期:2017-04-06
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