RAND Evaluates Integrated Care in the UK
There were 16 pilot programs in all. Overall, patients were less happy. Staff was happier. And:
We found no significant overall reduction in costs, though in case management sites there was an overall 9 per cent reduction in hospital costs.
This doesn’t surprise me.
Interesting analysis. The study claims that patients are less happy, because they don’t believe the new efforts help…this show it isn’t a good idea, because isn’t healthcare dominantly about the patients?
I agree with John, why would we consider these policies if the patient is less happy with their care.
What Intergrated care means:
“There was no single definition of integrated care and the concept was not rigidly predefined for the pilots. Projects were encouraged to set goals and metrics based on local circumstances and to experiment with new delivery models and new ways of working. Most pilots concentrated on horizontal integration between local services rather than vertical integration between hospitals and care in the community. Six projects focused on case management of patients at high risk of emergency hospital admission. “
There’s a significant amount of other evidence suggesting that integrated care raises costs.
But the idea just sounds so good that everybody automatically believes that costs will go down if everything it properly integrated. Sort of like they did in the Soviet Union.
And what paitiens didn’t like:
“Patients felt they were less likely to see the GP or nurse of their choice, or to be involved in decisions about their care. There was also a drop in those who felt listened to by social services.”
Similar to this side of the pond, the facilities that host the pilots have great moral and do really well. Mandate the change and the enthusiasm isn’t there.
There is bound to be a link between staff happiness and productivity.
I feel like most people getting medical care aren’t happy in general, in part because they are in poor health. And so, not too much weight can be put on it. That’s my personal view.
Exactly how less happy were they? Plus happiness is such a hard thing to measure. Put them on the right meds, they all might just be jolly!
“Happiness” can be a pretty easy thing to measure. The measurement is called “profit.” If you are not making a profit, chances are pretty good your customers aren’t very happy, or at least not as happy as they are with your competitors. Maybe profit in medicine isn’t such a bad idea.
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