Challenges and Opportunities for Person Centered Integrated Care Through the Life Course

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C. Ruth Wilson
James Appleyard
Juan E. Mezzich
Mohammed Abou-Saleh
Cal Gutkin
Chris van Weel
Ted Epperly


 Objective: 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.  

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