Challenges and Opportunities for Person Centered Integrated Care Through the Life Course
Keywords:Person and people centred care, primary care, health improvement, integration, life course
AbstractObjective: To examine the opportunities and challenges in achieving person centered integrated care through the life course. Methods: Critical literature review and evidence based analysis of person-centered integrated care through the life course, combined with expert consultation. The World Health Organization’s “Global Framework on Integrated People-Centred Health Services” is used as a basis. Results: Using the approach of the life cycle allows connection of persons’ current health status to their sociocultural, biological, and psychological context. Person centered medicine has as its central precept the relationship between the health professional and person seeking care. This principle is the link to primary health care, which is built on a lasting relationship with individuals and populations in their social context. The patient’s medical home provides one promising model of how health services can be organized to support the full achievement of person centered integrated care. Re-orientation of the health professional education towards generalism, and the development of metrics for measurement of person centered integrated care are required. In 2016 the global crisis in refugees is a particularly prominent challenge for the delivery of person centered integrated care. Conclusion: Universal health coverage can provide equitable access to person centered integrated care throughout the life course. Specialized expertise and skills are important for caring for persons with specific conditions at particular times in the life course. When care is well-integrated, transitions of care are smooth and the critical paradigm of person-centeredness is retained.
. International College of Person Centered Medicine. Geneva Declaration on Person and People centered integrated care for all. Intl. Journal of Person Centered Medicine 2014; 4 (2): 66-68.
. Appleyard J. Person-centered and integrated care across the life-cycle. International Journal of Person Centered Medicine. 2015; 5 (1): 15-20.
. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwads, Koss MP, Marks JS. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine, 1998; 14 (4): 245 – 258.
. McWhinney IR. The importance of being different. Br J Gen Pract. 1996; 46(408): 433–436
. World Health Organization 2009 Resolution 62.8 Primary health care, including health system strengthening http://apps.who.int/gb/e/e_wha62.html
. World Health Organization 2016. Framework on integrate, people-centred health services http://apps.who.int/gb/ebwha/pdf_files/EB138/B138_37-en.pdf
. Stange K, Ferrer R. The paradox of primary care. Ann Fam Med 2009: 7 (4): 293-299
. Weel C van, Sparks B. Caring for People’s Health Around the World: A Family Physician for Every Community. Fam Med 2007; 39: 616-7.
. Weel C van. Primary Health Care and Family Medicine at the Core of Health Care: Challenges and Priorities on How to Further Strengthen Their Potential. Front. Med. doi: 10.3389/fmed.2014.00037
. Epperly T. The patient-centred medical home in the USA. J Eval Clinc Pract 2011; 17(2): 373-5.
. Vasan A, Ellner A, Lawn SD, Gove S. Integrated care as a means to improve primary care delivery for adults and adolescents in the developing world BMC Med. 2014; 12: 6
. World Health Organization. Sexual and reproductive health: core competencies in primary care 2011 ISBN: 978 92 4 150100 2
. Durbin AJ, Selick A, Casson RI, Green L et al. Evaluating the implementation of health checks for adults with intellectual and developmental disabilities in primary care: The importance of organizational context. Intellectual and Developmental Disabilities, 2016; 54 (2): 136 DOI: 10.1352/1934-9556-54.2.136
. World Health Organization. Global Action Plan for the Prevention and Control of NCDs 2013-2020 http://www.who.int/nmh/events/ncd_action_plan/en/
. World Health Organization & Wonca. Integrating mental health into primary care. A global perspective 2008 <http://www.who.int/mental_health/policy/Integratingmhintoprimarycare2008_lastversion.pdf.
. World Health Organization. Global Strategy and Action Plan on Ageing and Health. http://www.who.int/ageing/global-strategy/en/
. UNHCR Global Trends. Forced displacement in 2014. Year in Review. http://www.unhcr.org/556725e69.pdf
. Langlois EV, Haines A, Tomson G, Ghaffar A. Refugees: towards better access to health-care services. Lancet 2016; 387 (10016): 319–321.
. World Federation for Mental Health. The Cairo Declaration on the Mental Health of Refugees wfmh.com/wp-content/uploads/2015/10/804727_Cairo-Declaration.pdf
. World Psychiatric Association. Position Statement on Europe Migrant and Refugee Crisis 2016 http://www.wpanet.org/detail.php?section_id=7&content_id=1772
. European Psychiatric Association. 2015 Position Statement on Psychiatric Care of Refugees in Europe. http://www.europsy.net/publications/position-statements/
. World Organization of Family Doctors. Istanbul Statement: Refugees should have access to equitable, affordable and high-quality health care services in all Europe, 2015. http://www.globalfamilydoctor.com/News/WONCAEuropelaunchesIstanbulStatement.aspx