文章基本信息

标题：How To Build an Integrated Neighborhood Approach to Support Community-Dwelling Older People?
本地全文：下载
作者：Hanna van Dijk ; Jane Cramm ; Anna Nieboer 等
期刊名称：International Journal of Integrated Care
电子版ISSN：1568-4156
出版年度：2016
卷号：16
期号：2
DOI：10.5334/ijic.1596
语种：English
出版社：Utrecht University, Maastricht University, Groningen University
摘要：Background: Although the need for integrated neighborhood approaches (INAs) is widely recognized, we lack insight into strategies like INA. We describe diverse Dutch INA partners’ experiences to provide integrated person- and population-centered support to community-dwelling older people using an adapted version of Valentijn and colleagues’ integrated care model. Our main objective was to explore the experiences with INA participation. We sought to increase our understanding of the challenges facing these partners and identify factors facilitating and inhibiting integration within and among multiple levels. Methods: Twenty-one interviews with INA partners (including local health and social care organizations, older people, municipal officers, and a health insurer) were conducted and subjected to latent content analysis. Results: This study showed that integrated care and support provision through an INA is a complex, dynamic process requiring multilevel alignment of activities. The INA achieved integration at the personal, service, and professional levels only occasionally. Micro-level bottom-up initiatives were not aligned with top-down incentives, forcing community workers to establish integration despite rather than because of meso- and macro-level contexts. Conclusions: Top-down incentives should be better aligned with bottom-up initiatives. This study further demonstrated the importance of community-level engagement in integrated care and support provision.