1 Centre for Applied Health Services Research, Department of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU2 Det Sundhedsvidenskabelige Fakultet, SDU3 Centre for Applied Health Services Research, Department of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU
Implementation of Integrated Home Care in EU Objective WHO put the fragmented delivery of health and social services for large groups of chronic conditions on the research agenda in 2002 as implemented in the call EU-FP7-HEALTH-2007-3.1.6. This granted project ( http://www.integratedhomecare.eu/ ) aims to develop a strategy for better clinical continuity in EU. Data and Method A systematic literature review on integrated care forms the base for design of an HTA of integrated home care (IHC) for chronic conditions in such a state of disablement that patient schools are not enough. The EUnetHTA Core Model for interventions focusing 9 domains is applied. Further, a SWOT-analysis of IHC determines a strategy for implementation of IHC in EU. Preliminary results 1. The efficacy of IHC for rehabilitation of frequent chronic conditions as stroke, COPD and heart failure (HF) has a common neuroeconomic explanation in the finding that the blood pressure declines 5-7 millimeter in your own home compared to a hospital environment which benefits limbic activity 2. In order to complement the evidence base for IHC a research program of seven trials and surveys is scheduled. This includes an EU-country-specific survey on financial and organizational barriers to IHC due to a fragmented administrative organization 3. The SWOT-analysis indicates in accordance with an empirical study that a feasible strategy of implementation is a meso-strategy combining the advantages of the goal-directedness of a centralized approach with the adaption to local conditions in a decentralized approach. This means that a regional level with direct cooperation between the administrative/financial and the clinical/specialist levels is focused. This meso- level is addressed by an international network of national specialist groups. Conclusion For improvement of clinical continuity in EU for chronic conditions as stroke, COPD and HF by IHC a HTA with a meso-strategy for dissemination seems to be an appropriate framework.
integrated care, activities of dayly living, early home supported discharge, health technology assessment, hawthorne effect