A Research Perspective 2014 NSW HEALTH SYMPOSIUM 19 June 2014 James Gillespie SESSION 3: Integrated Care and Health System Sustainability Associate Professor James Gillespie Director, Menzies Centre for Health Policy
A Research Perspective 2014 NSW HEALTH SYMPOSIUM 19 June 2014 James Gillespie
CF/KF 7 Nation Study • Te Whiringa Ora (TWO) Bay of Plenty NZ • Geriant, Noord Holland province, Netherlands • Torbay and Southern Devon Health and Care Trust, UK • The Norrtalje Model, Sweden • The Massachusetts General Care Management Program • The Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA), Quebec, Canada • HealthOne Mount Druitt, Sydney.
Findings • High touch vs high tech • Top-down v bottom up • Engagement of primary care • The role of ‘system spanners’
Conclusion • Most required some ‘central’ stimulus to get going. • Successful integration was initiated and led from the ‘bottom up’, with active involvement and leadership from the clinicians providing the care. • Each successful local initiative had to overcome funding and other barriers to sustainability from the broader health system.
References Anne-marieBoxall and James A Gillespie, Making Medicare: the politics of universal health care in Australia, UNSW Press 2013 Nick Goodwin et al, Providing integrated care for older people with complex needs: Key insights and lessons from seven cross national case studies, King’s Fund/Commonwealth Fund/Health System Performance Review Network, October 2013 www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/providing-integrated-care-for-older-people-with-complex-needs-kingsfund-jan14.pdf J. McNab, K Mallit and JA Gillespie (2013), Evaluation of HealthOne Mount Druitt, Menzies Centre for Health Policy, University of Sydney, available at http://ses.library.usyd.edu.au//bitstream/2123/8988/4/HOMDevaloct13.pdf Ellen Nolte, Emma Pitchforth (2014), What is the evidence on the economic impacts of integrated care? European Observatory on Health Systems and Policies. Policy Summary 11.