A community approach as a lever for integrated health & social care

Abstract

As a worldwide trend in health care and social care, new organizational arrangements and care perspectives focus more on a socio-ecological perspective towards integrated forms of health and social care (1,2,3). Based upon principles of social equity, sustainability and collective responsibility, a community-oriented Integrated Care Model is developed within health and social care (IC-model). This framework is acknowledged in both scientific papers (4) and international policy documents, including WHO-declarations (5). The community-oriented Integrated Care Model is developed as an alternative for the actual highly fragmented care delivery, the recently growing interplay between social care and health care and the access problem to health care and social care for the most socially vulnerable citizens (6,7). This framework is characterized by a community orientation, where integrated primary health care and social care can contribute to more positive health outcomes and social equity (8). In this exploratory study, an interdisciplinary research team (i.e. welfare and health academics) examine how a community (health) approach can be a lever for integrated health care and social care, and which roles community (health) workers can play in this approach. In this study the community-oriented (health) approach is scrutinized in the context of primary health care in Flanders (Belgium). Based on ethnographic research methodology, namely a combination of literature review, fieldwork (participant observation and document analyses) and interviews with (health and welfare) professionals, patients and informal caregivers (n=40), this research question is studied in three particular community health centres in Ghent (Flanders). The results will be available at the conference 2017. References : 1- Bentley M. An ecological public health approach to understanding the relationships between sustainable urban environments, public health and social equity. Health Promotion International, 2014;29(3): 528–37. 2- Conill EM. The socio-ecological and primary care approach to the creation of universal health systems in the work of Hernan san Martin. Cienc. saude coletiva. 2016;21(1):173-178. 3- De Maeseneer J, et al., Together we change. Eerstelijnsgezondheidszorg: nu meer dan ooit! Brussel. 2014 4- Lloyd J. and Wait S. Integrated Care: A guide for policymakers. London: Alliance for Health and the Future. 2005 5- World Health Organization (WHO). The World Health Report 2008: Primary Health Care – Now More Than Ever. 2008, Geneva. 6- Enthoven AC. Integrated delivery systems: the cure for fragmentation. Am J Manag Care. 2009;15(10):284-90. 7- Xyrichis A., & Lowton K. What fosters or prevents interprofessional teamworking in primary and community care? A literature review. International Journal of Nursing Studies, 2008;45: 140-153. 8- Shi L, The Impact of Primary Care: A Focused Review. Scientifica, 2012: 22.