RESUMEN
The COVID-19 pandemic puts health and care systems under pressure globally. This current paper highlights challenges arising in the care for older and vulnerable populations in this context and reflects upon possible perspectives for different systems making use of nested integrated care approaches adapted during the work of the EU-funded project VIGOUR ("Evidence based Guidance to Scale-up Integrated Care in Europe", funded by the European Union's Health Programme 2014-2020 under Grant Agreement Number 826640).
RESUMEN
Patients with multimorbidity (defined as the co-occurrence of multiple chronic diseases) frequently experience fragmented care, which increases the risk of negative outcomes. A recently proposed Integrated Multimorbidity Care Model aims to overcome many issues related to fragmented care. In the context of Joint Action CHRODIS-PLUS, an implementation methodology was developed for the care model, which is being piloted in five sites. We aim to (1) explain the methodology used to implement the care model and (2) describe how the pilot sites have adapted and applied the proposed methodology. The model is being implemented in Spain (Andalusia and Aragon), Lithuania (Vilnius and Kaunas), and Italy (Rome). Local implementation working groups at each site adapted the model to local needs, goals, and resources using the same methodological steps: (1) Scope analysis; (2) situation analysis-"strengths, weaknesses, opportunities, threats" (SWOT) analysis; (3) development and improvement of implementation methodology; and (4) final development of an action plan. This common implementation strategy shows how care models can be adapted according to local and regional specificities. Analysis of the common key outcome indicators at the post-implementation phase will help to demonstrate the clinical effectiveness, as well as highlight any difficulties in adapting a common Integrated Multimorbidity Care Model in different countries and clinical settings.
Asunto(s)
Enfermedad Crónica/terapia , Prestación Integrada de Atención de Salud/métodos , Multimorbilidad , Planificación de Atención al Paciente , Adulto , Anciano , Anciano de 80 o más Años , Prestación Integrada de Atención de Salud/organización & administración , Femenino , Humanos , Lituania , Masculino , Persona de Mediana Edad , Planificación de Atención al Paciente/organización & administración , Proyectos Piloto , Desarrollo de Programa , Ciudad de Roma , EspañaRESUMEN
В 2004 году в рамках комплексного плана лечения диабета в Андалузии была разработана программа раннего выявления диабетической ретинопатии. В регионе проживает 8,4 млн. человек; по оценкам, уровень заболеваемости сахарным диабетом составляет около 12%. В настоящее время в рамках программы было обследовано 424 648 пациентов, выполнено 753 523 ретинографий, и охват целевого населения достиг 95%. Программа способствует более широкому вовлечению специалистов первичной медико-санитарной помощи и использованию цифровых решений.
Asunto(s)
Diabetes Mellitus , Retinopatía Diabética , Diagnóstico Precoz , Atención Primaria de Salud , EspañaRESUMEN
In 2004, a programme for early detection of diabetic retinopathy was introduced within the comprehensive plan for diabetes in Andalusia. The region has 8.4 million inhabitants and an estimated rate of diabetes mellitus of about 12%. Currently, 424 648 patients have participated in the programme, with 753 523 retinographies performed, reaching 95% of the target population. The programme enhances the participation of primary health care professionals and the use of digital solutions.