Wankah Paul, Gordon Dara, Shahid Simone, Chandra Shivani, Abejirinde Ibukun-Oluwa, Yoon Rosanra, Wodchis Walter P, O'Campo Patricia, Gray Carolyn Steele, Clark Nancy, Shaw James
University of Toronto, CA.
Women's College Hospital, CA.
Int J Integr Care. 2023 Oct 19;23(4):6. doi: 10.5334/ijic.7614. eCollection 2023 Oct-Dec.
Over the last three decades, integrated care has emerged as an important health system strategy to improve population health while addressing the unique needs of structurally marginalised communities. However, less attention has been given to the role of integrated care in addressing issues related to inequities in health and health care. In this commentary we introduce the concept of Equity Promoting Integrated Care (EPIC) that situates integrated care in a social justice context to frame the actions necessary to center equity as a priority for integrated care. We suggest that efforts to advance the design and implementation of integrated care should focus on three avenues for future research and practice, namely, the collaborative mobilization of a global network of integrated care stakeholders to advocate for social justice and health equity, investing in equity-focused approaches to implementation science that highlight the importance of social concepts such as colonialism and intersectionality to advance the theory and practice of implementing EPIC models of care, and leveraging innovative approaches to measuring equity-related aspects of integrated care to inform continuous improvement of health systems.
在过去三十年里，整合照护已成为一项重要的卫生系统战略，旨在改善人群健康状况，同时满足结构上处于边缘地位社区的特殊需求。然而，整合照护在解决与健康及医疗保健不平等相关问题方面所发挥的作用却较少受到关注。在本评论中，我们引入了促进公平的整合照护（EPIC）这一概念，将整合照护置于社会正义背景下，以规划将公平作为整合照护优先事项所需采取的行动。我们建议，推进整合照护设计与实施的努力应聚焦于未来研究与实践的三条途径，即协同动员整合照护利益相关者的全球网络，倡导社会正义与健康公平；投资于以公平为重点的实施科学方法，强调殖民主义和交叉性等社会概念对推进EPIC照护模式实施理论与实践的重要性；利用创新方法衡量整合照护中与公平相关的方面，为卫生系统的持续改进提供信息。
