Person-centred Integrated Care (PIC) Networks supporting Healthy Ageing in Place

以人为本的综合护理 (PIC) 网络支持健康养老

• 批准号: MR/Y010922/1
• 负责人: Sarah Harper
• 金额: $ 42.21万
• 依托单位: University of Oxford
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY010922%2F1
• 关键词: Person; centred; Integrated; Care; PIC

The UK has an ageing population with increasingly complex health and care needs, linked to growing rates of long-term illness and multi-morbidity that are disproportionately high in the most deprived communities. The resources for formal health and care services such as the NHS and Local Authorities providing social care, are not keeping pace with demand . Prevention of transitions to poor health and higher care needs, and reduction of health inequalities between the most and least deprived groups in society, is essential for the long-term sustainability of the health and care system. The key challenge that we will address is how to prevent or delay transitions to more intensive forms of care as people age, and how to mitigate the impact of those transitions when they do occur. There is a growing evidence that local-level community based support, such as voluntary organisations and connection services such as social prescribing, play a key role in supporting people's health and well-being as they age. Over the past year we have established a multi-disciplinary cross-sector team uniting inputs from medical statistics, health economics, sociology, anthropology and design. Through this collaboration we have developed the concept of Person-centred Integrated Care (PIC) Networks, tailored to existing assets of diverse local settings, as novel interventions to support older people's health and wellbeing as they age in place. This draws on our understanding of the co-design of health and care interventions for communities and the impact of the environment on health and wellbeing as individuals age. This project is proof-of-concept and feasibility research, where we aim to elucidate the role and efficacy of local person-centred integrated care networks in delaying transitions to more intensive levels of care needs, and ameliorating care needs on transition. The study will take the example of the Leeds Neighbourhood Network, which has already been demonstrated to have local efficacy and has been considered by another city council (Birmingham), and explore whether this network model is generalisable, scalable and sustainable.Oxfordshire, the city of Oxford, surrounding small towns and rural communities, has been selected for its diversity of socio-economic and geographic communities in which to test the feasibility of establishing new PIC Networks from the principles of the Leeds model. This project will employ a mixture of qualitative and quantitative research methods across five complementary, concurrent work packages: statistical and economic analysis of population health data sets to develop a set of indicators for evaluation of PIC Networks; qualitative interviews and workshops for stakeholder engagement to identify key people and organisations who might comprise a local PIC Network; design and ethnographic methods to map local assets for potential inclusion in PIC Networks, including the built environment and technological resources, and connectivity between them; and co-creation techniques for citizen engagement on potential outcomes of PIC Network implementation that promote older people's health and wellbeing. Findings from the four concurrent Work Packages will be brought together through two knowledge exchange workshops with key stakeholders, in which we will co-develop and agree recommendations for implementing PIC Networks. This will allow us to devise an appropriate policy agenda which supports inclusively designed PIC Networks as part of a strategy to promote health in later life, and delay age-related transitions into frailty and ill-health.

英国人口老龄化，健康和护理需求日益复杂，与长期疾病和多种疾病的发病率不断上升有关，这些疾病在最贫困的社区中不成比例地高。用于正规保健和护理服务的资源，如国家卫生服务体系和提供社会护理的地方当局，跟不上需求的步伐。防止向健康状况不佳和更高的护理需求过渡，减少社会中最贫困和最贫困群体之间的健康不平等，对于保健和护理系统的长期可持续性至关重要。我们将解决的关键挑战是如何防止或延迟随着人们年龄的增长而向更密集的护理形式过渡，以及如何在这些过渡发生时减轻其影响。越来越多的证据表明，地方一级的社区支持，如志愿组织和社会处方等联系服务，在支持人们老年时的健康和福祉方面发挥着关键作用。在过去的一年里，我们建立了一个多学科的跨部门团队，将医疗统计学，卫生经济学，社会学，人类学和设计的投入结合起来。通过这种合作，我们制定了以人为本的综合护理网络的概念，根据不同地方环境的现有资产量身定制，作为新的干预措施，以支持老年人在老年时的健康和福祉。这借鉴了我们对社区健康和护理干预措施的共同设计以及环境对个人年龄健康和福祉的影响的理解。这个项目是概念验证和可行性研究，我们的目标是阐明本地以人为本的综合护理网络在延迟过渡到更密集的护理需求水平，并改善过渡的护理需求的作用和功效。这项研究将以利兹邻里网络为例，该网络已被证明具有地方效力，并已得到另一个市理事会的考虑（伯明翰），并探讨这种网络模式是否具有可推广性、可扩展性和可持续性。牛津郡、牛津市、周边小城镇和农村社区，选择这些国家是因为其社会经济和地理社区的多样性，以测试根据利兹模式的原则建立新的事先知情同意网络的可行性。该项目将在五个互补的并行工作包中采用定性和定量研究方法：对人口健康数据集进行统计和经济分析，以制定一套评估PIC网络的指标;为利益攸关方参与进行定性访谈和研讨会，以确定可能组成当地PIC网络的关键人员和组织;设计和人种学方法，以绘制可能纳入PIC网络的当地资产，包括建筑环境和技术资源，以及它们之间的连通性;以及共同创造技术，使公民参与PIC网络实施的潜在成果，促进老年人的健康和福祉。四个并行工作包的结果将通过与主要利益攸关方的两个知识交流研讨会汇集在一起，我们将共同制定和商定实施PIC网络的建议。这将使我们能够制定适当的政策议程，支持包容性设计的PIC网络，作为促进晚年健康的战略的一部分，并推迟与年龄相关的向虚弱和健康不良的转变。