Organizing integrated care for older persons: strategies in Sweden

• ABSTRACT Introduction The increasing differentiation of welfare services, and particularly of care for older persons, calls for improved integration across the involved organizations. Older persons often have complex needs and they receive care from many different providers of health/social care and rehabilitation. There is a risk of fragmentation of responsibilities, which may result in efficiency and quality problems, such as duplications, gaps and discontinuity. This may in turn lead to concerns for the older persons, primarily dealing with unmet care needs. Purpose/methods The purpose of the study was to analyse ways of organizing integrated care for older persons in Sweden during the past decade. The data consist of 62 cases of development work, described in official reports. A meta-analysis of cases was performed, including content analysis of each case. A theoretical framework comprising different forms of integration and strategies was applied. Results The development of local health care systems constitutes an important co-operation strategy, involving new ideas about organizing integrated care. The focus includes local care, health promotion and co-operation across organizational borders. The primary element is to stimulate innovation and new organizational approaches for older persons with specific diagnoses,(e.g. stroke and heart failure), and medical specialists located outside the hospital. However, the increasing use of contracting strategies, such as consumer choice models are characterized by differentiation and less emphasis on integration. Conclusions The development of local health care systems for older persons during the past decade appeared to be a promising strategy as regards health promotion and integration. However, contracting strategies seemed to be problematic regarding integration between organizations.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

Nyckelord

organization

integrated care

older persons

Publikations- och innehållstyp

vet (ämneskategori)

kon (ämneskategori)