Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, Rome, Italy.
Ann Ist Super Sanita. 2019 Jul-Sep;55(3):276-282. doi: 10.4415/ANN_19_03_14.
The increasingly complex and multidimensional care request, combined with the presence of increasingly aware and demanding patients, accentuates the need for new strategies to preserve health systems economic sustainability. Therefore, integration mechanisms reveal an essential condition for ensuring continuity of care. The paper reviews the main literature available on the integration of heal services and relates it to rare diseases. The literature identifies several system levers for the effective design and implementation of integrated care frameworks, namely: political support and commitment, governance, stakeholder engagement, organisational change, leadership, collaboration and trust, workforce education and training, patient empowerment, financing and incentives, ICT infrastructure and solutions, monitoring and evaluation system.
日益复杂和多维的护理需求,加上日益意识到并要求更高的患者,凸显了需要新的策略来保持卫生系统经济可持续性。因此,整合机制揭示了确保护理连续性的必要条件。本文综述了关于医疗服务整合的主要文献,并将其与罕见病联系起来。文献确定了有效设计和实施综合护理框架的几个系统杠杆,即:政治支持和承诺、治理、利益相关者参与、组织变革、领导力、合作和信任、劳动力教育和培训、患者赋权、融资和激励、信息和通信技术基础设施和解决方案、监测和评估系统。