A model of successful ageing in British populations
| Autor: | Martin Mc Kee, Martyn Sherriff, Yvonne G Doyle |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Gerontology
Integrated services Aging Models Statistical business.industry Public Health Environmental and Occupational Health MEDLINE Reproducibility of Results Public relations Middle Aged Models Theoretical Mental health Health Surveys Homophily Integrated care England Successful ageing Medicine Humans Health delivery Centrality business Life Style |
| Zdroj: | European journal of public health. 22(1) |
| ISSN: | 1464-360X |
| Popis: | Background: Socially marginalised people with mental health disorders have complex needs that require integrated care from different services. However, in many western countries, fragmentation in mental health and social care delivery systems is highly prevalent. European countries have implemented different organisational mechanisms at the service or at the system levels to address this issue. Due to the complexity and diversity of mental health and social care delivery systems, integration of care is challenging to describe and assess. Method: Within a European research project on mental health in socially marginalised groups, data on referrals and service meetings were collected across mental health and social care services in 8 deprived areas of several European capitals in 2008-2009 (London (2 areas), Brussels, Paris, Dublin, Vienna, Amsterdam, Warsaw). The relations declared between services were processed with Social Network Analysis (SNA) indicators on density of ties, centrality of services, and homophily, to assess three levels of integration of care: linkage, coordination, and full integration. Results: In each area, the number of services selected ranged from 32 to 54. The levels of linkage between mental health and social care services were low (average degrees ranged from 3.36 in Paris to 9.89 in London). Services were more likely to develop relationships with similar services (homophily) across all areas. In some areas, the centrality of some services was high, e.g. general hospitals in Paris. General health and generic social care services were more likely to take on brokerage roles between mental health and targeted social care services, although these services were not always mandated for coordination. There were very few fully integrated services, and generally in peripheral positions. Conclusions: SNA measurements offer an innovative method to assess the structure of relationships between health and social care services at the system level. Despite the diversity of health delivery systems across European capitals, fragmentation in mental health and social care is an issue everywhere. The three levels of care integration, i.e. linkage, coordination, and full integration, should address different users' needs and policy operations. However, the study revealed gaps in the achievement of each of those levels. The results are particularly relevant for policy-makers to monitor and compare the implementation of care integration policies across Europe over time. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|