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June 11th, 2013

Incentivising Integrated Care

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Estimated reading time: 5 minutes

Blog Editor

June 11th, 2013

Incentivising Integrated Care

0 comments

Estimated reading time: 5 minutes

by Sherry Merkur, Anna Maresso and David McDaid

Health systems are subject to a number of pressures that impact on their ability to deliver effective services, not least those stemming from ageing populations and the growing number of patients suffering from chronic conditions and co-morbidities. In a number of countries, integrated care models are being explored as a means of meeting the challenges of changing disease burdens, delivering effective health care as well as bolstering the sustainability of their health systems. However, there are many possible ways of promoting the better integration of care, with the use of (appropriate) financial incentives being one method to achieve this goal.

The most recent issue of Eurohealth covers some recent developments in this and other areas and has just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner).

This issue’s Eurohealth Observer section starts with an overview that examines some innovative integrated care schemes, payment models and financial incentives that are being implemented in several countries. The authors report on the current state of evidence and highlight that in many cases, rigorous evaluations of implemented models are needed before their suitability and effectiveness can be more accurately determined. Eight case study articles follow, providing more in depth information on incentive mechanisms, and importantly, placing them within their specific country and health system contexts.

In the Eurohealth International section, Thomas Plochg discusses why the existing health workforce in Europe is poorly fit for purpose when it comes to chronic diseases and especially multi-morbidity. He provides suggestions on how a reconfiguration strategy could be successfully developed and implemented to support more sustainable health systems.

Eurohealth Systems and Policies showcase articles on the United Kingdom, the Republic of Moldova, Canada and the Netherlands. Anita Charlesworth presents the rapid increase in UK health spending over the last decade, which has recently been halted to include tighter controls on public health spending. She then discusses the fiscal sustainability challenge that the UK and other governments will face over the long-term. Since 2010, the Republic of Moldova has provided universal access to primary care irrespective of citizens’ insurance coverage. In their article, Domente and colleagues detail the network of primary care facilities that have been central to improved access, but also identify where additional improvements can be achieved through future reform.

Despite many positive health system outcomes in Canada, Greg Marchildon offers evidence on why primary care has been shown to be weak when compared internationally. He argues that the protected status of doctors, as independent contractors paid by fee-for-service, is not generally suited to primary care practice. Finally, Nucciarelli and Ivanovic discuss how Dutch health system reform has radically modified the role of hospitals in a managed competition market. The article then proposes potential trends by analysing changes in the dealings of hospital management towards insurers and patients.

In Eurohealth Monitor, we share with you two new books, one on the changing role of health system governance and the other on divergent trends in health policy, while the news section provides timely developments in health policy, both nationally and internationally.

We hope that you find this issue informative and interesting – we welcome comments to the editors.

Read the full issue (PDF).

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