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Improved Health System Performance through better Care Coordination

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  • Maria M. Hofmarcher
  • Howard Oxley
  • Elena Rusticelli
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    Abstract

    This report attempts to assess whether -- and to what degree - better care coordination can improve health system performance in terms of quality and cost-efficiency. Coordination of care refers to policies that help create patient-centred care that is more coherent both within and across care settings and over time. Broadly speaking, it means making health-care systems more attentive to the needs of individual patients and ensuring they get the appropriate care for acute episodes as well as care aimed at stabilising their health over long periods in less costly environments. These issues are of particular interest to patients with chronic conditions and the elderly who may find it difficult to "navigate" fragmented health-care systems that are often found in OECD countries. Interest in coordination of care issues is increasing Growing interest in these issues has reflected a shift in the demands placed on health-care services. Chronic conditions have become progressively more important and are absorbing a growing share of health-care budgets. Since most of the chronically ill are elderly, this share can be expected to rise as populations age over coming decades. At the same time, many reports suggest that the quality of care that the chronically ill receive may need improvement. With these developments occurring in a context of tight public finance, some countries have been attempting to improve both the quality of care provided to the chronically ill and reduce cost pressures via changes to the architecture of health-care systems that encourage greater care coordination... L'objet de ce rapport est de tenter d'apprécier si - et, le cas échéant, dans quelle mesure - une meilleure coordination des soins est susceptible d'améliorer la performance des systèmes de santé en termes de qualité et d'efficience au regard du coût. Par coordination des soins on entend les mesures de nature à aider à instaurer une prise en charge centrée sur le patient qui soit plus cohérente aussi bien à l'intérieur d'un même cadre de soins qu'entre différents cadres de soins, et dans le temps. Plus généralement, il s'agit de faire en sorte que les systèmes de santé soient plus attentifs aux besoins individuels des patients et de faire en sorte que ceux-ci reçoivent les soins appropriés à l'occasion d'épisodes aigus, ainsi que des soins destinés à stabiliser leur état de santé, dans une perspective à long terme, dans un environnement moins coûteux. Ces questions revêtent une importance toute particulière pour les malades chroniques et pour les personnes âgées qui trouveront sans doute difficile de « naviguer » à l'intérieur de systèmes de santé fragmentés comme c'est souvent le cas dans les pays de l'OCDE. On s'intéresse de plus en plus à la problématique de la coordination des soins L'intérêt croissant pour cette question reflète un déplacement des attentes à l'égard des services de santé. Les maladies chroniques sont de plus en plus fréquentes et absorbent une part croissante des budgets de santé. Les maladies chroniques concernant, le plus souvent, les personnes âgées, on peut penser, la population vieillissant, que c'est un aspect des systèmes de santé qui prendra de plus en plus d?importance au cours des décennies à venir. Dans le même temps, de nombreux rapports signalent que la qualité des soins dispensés aux malades chroniques pourrait sans doute être améliorée. Ces évolutions intervenant dans un contexte difficile pour les finances publiques, certains pays s'efforcent d'améliorer la qualité des soins dispensés aux malades chroniques et de réduire la pression sur les coûts en repensant complètement l'architecture de leur système de santé, de façon à encourager une plus grande coordination des soins...

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    Bibliographic Info

    Paper provided by OECD Publishing in its series OECD Health Working Papers with number 30.

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    Date of creation: 12 Dec 2007
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    Handle: RePEc:oec:elsaad:30-en

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    Cited by:
    1. Mousquès, Julien & Bourgueil, Yann & Le Fur, Philippe & Yilmaz, Engin, 2010. "Effect of a French experiment of team work between general practitioners and nurses on efficacy and cost of type 2 diabetes patients care," Health Policy, Elsevier, vol. 98(2-3), pages 131-143, December.
    2. Visca, Modesta & Donatini, Andrea & Gini, Rosa & Federico, Bruno & Damiani, Gianfranco & Francesconi, Paolo & Grilli, Leonardo & Rampichini, Carla & Lapini, Gabriele & Zocchetti, Carlo & Di Stanislao,, 2013. "Group versus single handed primary care: A performance evaluation of the care delivered to chronic patients by Italian GPs," Health Policy, Elsevier, vol. 113(1), pages 188-198.
    3. Guillaume Chevillard & Julien Mousquès & Véronique Lucas-Gabrielli & Yann Bourgueil & Stéphane Rican & Gérard Salem, 2013. "Maisons et pôles de santé : places et impacts dans les dynamiques territoriales d'offre de soins en France," Working Papers DT57, IRDES institut for research and information in health economics, revised Nov 2013.
    4. Marion Haas & Jane Hall & Gisselle Gallego, 2009. "Evidence for funding, organising and delivering health care services targeting secondary prevention and management of chronic conditions. CHERE Working Paper 2009/6," Working Papers 2009/6, CHERE, University of Technology, Sydney.

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