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Patient-provider disconnect: A qualitative exploration of understanding and perceptions to care integration

BACKGROUND: Integrated care has been well-recognized as a solution to improve quality of care for patients with complex needs. As Singapore increasingly develops and promotes integrated models of care, it is unclear if providers, patients, and caregivers share similar understanding of changes in the...

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Autores principales: Lai, Yi Feng, Lum, Andrew Yew Wai, Ho, Emily Tse Lin, Lim, Yee Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659677/
https://www.ncbi.nlm.nih.gov/pubmed/29077758
http://dx.doi.org/10.1371/journal.pone.0187372
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author Lai, Yi Feng
Lum, Andrew Yew Wai
Ho, Emily Tse Lin
Lim, Yee Wei
author_facet Lai, Yi Feng
Lum, Andrew Yew Wai
Ho, Emily Tse Lin
Lim, Yee Wei
author_sort Lai, Yi Feng
collection PubMed
description BACKGROUND: Integrated care has been well-recognized as a solution to improve quality of care for patients with complex needs. As Singapore increasingly develops and promotes integrated models of care, it is unclear if providers, patients, and caregivers share similar understanding of changes in the healthcare system. OBJECTIVES: This study aims at exploring three dimensions of care integration: a) understanding of integration; b) challenges and c) changes perceived as essential among three distinct stakeholder groups: providers, patients and caregivers. METHODS: This qualitative study was conducted among 41 care providers (clinicians and administrators) and care consumers (patients and caregivers) in Singapore utilizing 29 semi-structured interviews and 2 focus group discussions. Study participants were selected by purposive, snowball sampling from various clinical settings. Data were transcribed, familiarized, coded and analyzed using a conceptual framework. RESULTS: Understanding of care integration was generally lacking among patient and caregivers. Most of them focused on healthcare costs and accessibility of services. Providers characterized care integration in clinical process terms and had a more systems view of the concept. Most participants viewed resource constraints as a key challenge in integrating care. Additionally, providers expressed the need for patients and their families to play a greater role in managing their health. Individuals and the community are key components of an integrated care system in the future. Reliance on the healthcare system alone is not sustainable. CONCLUSIONS: Patients, caregivers and providers have varying degrees of understanding towards care integration. The success of engaging stakeholders on the ground to be active participants in the healthcare system integration process requires policymakers and healthcare leaders to increase patient engagement efforts and to better appreciate the challenges faced by the healthcare workers in the rapidly changing national and global healthcare landscape.
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spelling pubmed-56596772017-11-09 Patient-provider disconnect: A qualitative exploration of understanding and perceptions to care integration Lai, Yi Feng Lum, Andrew Yew Wai Ho, Emily Tse Lin Lim, Yee Wei PLoS One Research Article BACKGROUND: Integrated care has been well-recognized as a solution to improve quality of care for patients with complex needs. As Singapore increasingly develops and promotes integrated models of care, it is unclear if providers, patients, and caregivers share similar understanding of changes in the healthcare system. OBJECTIVES: This study aims at exploring three dimensions of care integration: a) understanding of integration; b) challenges and c) changes perceived as essential among three distinct stakeholder groups: providers, patients and caregivers. METHODS: This qualitative study was conducted among 41 care providers (clinicians and administrators) and care consumers (patients and caregivers) in Singapore utilizing 29 semi-structured interviews and 2 focus group discussions. Study participants were selected by purposive, snowball sampling from various clinical settings. Data were transcribed, familiarized, coded and analyzed using a conceptual framework. RESULTS: Understanding of care integration was generally lacking among patient and caregivers. Most of them focused on healthcare costs and accessibility of services. Providers characterized care integration in clinical process terms and had a more systems view of the concept. Most participants viewed resource constraints as a key challenge in integrating care. Additionally, providers expressed the need for patients and their families to play a greater role in managing their health. Individuals and the community are key components of an integrated care system in the future. Reliance on the healthcare system alone is not sustainable. CONCLUSIONS: Patients, caregivers and providers have varying degrees of understanding towards care integration. The success of engaging stakeholders on the ground to be active participants in the healthcare system integration process requires policymakers and healthcare leaders to increase patient engagement efforts and to better appreciate the challenges faced by the healthcare workers in the rapidly changing national and global healthcare landscape. Public Library of Science 2017-10-27 /pmc/articles/PMC5659677/ /pubmed/29077758 http://dx.doi.org/10.1371/journal.pone.0187372 Text en © 2017 Lai et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lai, Yi Feng
Lum, Andrew Yew Wai
Ho, Emily Tse Lin
Lim, Yee Wei
Patient-provider disconnect: A qualitative exploration of understanding and perceptions to care integration
title Patient-provider disconnect: A qualitative exploration of understanding and perceptions to care integration
title_full Patient-provider disconnect: A qualitative exploration of understanding and perceptions to care integration
title_fullStr Patient-provider disconnect: A qualitative exploration of understanding and perceptions to care integration
title_full_unstemmed Patient-provider disconnect: A qualitative exploration of understanding and perceptions to care integration
title_short Patient-provider disconnect: A qualitative exploration of understanding and perceptions to care integration
title_sort patient-provider disconnect: a qualitative exploration of understanding and perceptions to care integration
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659677/
https://www.ncbi.nlm.nih.gov/pubmed/29077758
http://dx.doi.org/10.1371/journal.pone.0187372
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