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Scaling-up an integrated care for patients with non-communicable diseases : an analysis of healthcare barriers and facilitators in Slovenia and Belgium
Črt Zavrnik, Katrien Danhieux, Miriam Hurtado Monarres, Nataša Stojnić, Majda Mori-Lukančič, Monika Martens, Zalika Klemenc-Ketiš, Edwin Wouters, Josefien Van Olmen, Tonka Poplas-Susič, 2021, izvirni znanstveni članek

Opis: Introduction: Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium. Methods: This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries. Results: Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals. Conclusions: This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.
Ključne besede: scale-up, noncommunicable diseases, patientcentered care, primary healthcare, integrated healthcare
Objavljeno v DKUM: 22.10.2024; Ogledov: 0; Prenosov: 3
.pdf Celotno besedilo (428,11 KB)
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2.
Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project) : a study protocol
Monika Martens, Edwin Wouters, Josefien Van Olmen, Zalika Klemenc-Ketiš, Srean Chhim, Savina Chham, Verle Buffel, Katrien Danhieux, Nataša Stojnić, Črt Zavrnik, Tonka Poplas-Susič, Win Van Damme, Por Ir, Roy Remmen, Grace Marie V Ku, Kerstin Klipstein-Grobusch, Daniel Boateng, 2022, izvirni znanstveni članek

Opis: Introduction Integrated care interventions for type 2 diabetes (T2D) and hypertension (HT) are effective, yet challenges exist with regard to their implementation and scale-up. The ‘SCale-Up diaBetes and hYpertension care’ (SCUBY) Project aims to facilitate the scale-up of integrated care for T2D and HT through the co-creation and implementation of contextualised scale-up roadmaps in Belgium, Cambodia and Slovenia. We hereby describe the plan for the process and scale-up evaluation of the SCUBY Project. The specific goals of the process and scale-up evaluation are to (1) analyse how, and to what extent, the roadmap has been implemented, (2) assess how the differing contexts can influence the implementation process of the scale-up strategies and (3) assess the progress of the scale-up. Methods and analysis A comprehensive framework was developed to include process and scale-up evaluation embedded in implementation science theory. Key implementation outcomes include acceptability, feasibility, relevance, adaptation, adoption and cost of roadmap activities. A diverse range of predominantly qualitative tools—including a policy dialogue reporting form, a stakeholder follow-up interview and survey, project diaries and policy mapping—were developed to assess how stakeholders perceive the scale-up implementation process and adaptations to the roadmap. The role of context is considered relevant, and barriers and facilitators to scale-up will be continuously assessed. Ethics and dissemination Ethical approval has been obtained from the Institutional Review Board (ref. 1323/19) at the Institute of Tropical Medicine (Antwerp, Belgium). The SCUBY Project presents a comprehensive framework to guide the process and scale-up evaluation of complex interventions in different health systems. We describe how implementation outcomes, mechanisms of impact and scale-up outcomes can be a basis to monitor adaptations through a co-creation process and to guide other scale-up interventions making use of knowledge translation and co-creation activities.
Ključne besede: diabetes and hypertension care, Belgium, Cambodia, Slovenia
Objavljeno v DKUM: 27.06.2024; Ogledov: 139; Prenosov: 8
.pdf Celotno besedilo (1,50 MB)
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