Wodchis Walter P, Shaw James, Sinha Samir, Bhattacharyya Onil, Shahid Simone, Anderson Geoffrey
Walter P. Wodchis is a professor in the Institute of Health Policy, Management, and Evaluation (IHPME), University of Toronto, in Ontario.
James Shaw is a scientist at the Women's College Hospital Institute for Health System Solutions and Virtual Care (WHIV), in Toronto.
Health Aff (Millwood). 2020 Apr;39(4):697-703. doi: 10.1377/hlthaff.2019.01587.
As high-income countries face the challenge of providing better and more efficient integrated health and social care to high-needs and high-cost populations, they may require innovative policy supports at both the national and local levels. We categorized policy supports into four areas: governance and partnerships; workforce and staffing; financing and payment; and data sharing and use. Our structured survey of thirty integrated health and social care programs in high-income countries in 2018 found that the majority of programs had policy supports in two or more areas, with supports for governance and partnerships and for workforce and staffing being the most common. Financing and payment and data sharing and use were less common. Local partnerships empowered integration across sectors, and new staff roles that spanned health and social care embedded this integration in care delivery. National policies-including bundled financing and investment in data-enabled integration and cross-sector accountability.
随着高收入国家面临为高需求和高成本人群提供更好、更高效的综合健康和社会护理的挑战，它们可能需要国家和地方层面的创新政策支持。我们将政策支持分为四个领域：治理与伙伴关系；劳动力与人员配置；融资与支付；以及数据共享与使用。我们在2018年对高收入国家的30个综合健康和社会护理项目进行的结构化调查发现，大多数项目在两个或更多领域获得了政策支持，其中对治理与伙伴关系以及劳动力与人员配置的支持最为常见。融资与支付以及数据共享与使用则不太常见。地方伙伴关系促进了跨部门整合，而跨越健康和社会护理领域的新员工角色将这种整合融入了护理服务中。国家政策包括捆绑式融资以及对数据驱动的整合和跨部门问责制的投资。
