Measurement of social- and health outcomes in integrated settings
This document describes those actions which are the most important to measure the regional system and provide more “out – of – hospital” services as well as some social services. This is due the fact that during recent years we have seen a plethora of new management approaches for improving organiza...
Published in: | International Journal of Integrated Care |
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Main Authors: | , , |
Format: | Article in Journal/Newspaper |
Language: | English |
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Ubiquity Press
2017
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Online Access: | https://www.ijic.org/jms/article/view/3624 https://doi.org/10.5334/ijic.3624 |
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measurement |
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measurement Itkonen, Pentti Tepponen, Merja Klemola, Katja Measurement of social- and health outcomes in integrated settings |
topic_facet |
measurement |
description |
This document describes those actions which are the most important to measure the regional system and provide more “out – of – hospital” services as well as some social services. This is due the fact that during recent years we have seen a plethora of new management approaches for improving organizational performance. So far all these approaches in social and healthcare have only meant providing great volumes, measuring and prizing single products, supervising of contracts, controlling and calculating budgets and adding regulation. In spite of that the costs continue to rise at an unsustainable rate in all countries.Social- and healthcare organizations in different countries are focused on costs, not social and health outcomes and values. This calls for a new and more holistic measurement of health outcomes and wellbeing in society and also more understanding of digitalized services. To-day the systems reward those providers, public or private who shift costs and bill for more services, not those providers who deliver the most value. In the care chain the focus is on minimizing the cost for each piece of intervention and limiting services rather than on maximizing value over the entire care cycle. Moreover, without integrated organization structure and comprehensive outcome measurement, it is hard to know what improves value and what does not.The measurement is possible to implement especially in Finland and in South Karelia Social- and Healthcare District (EKSOTE) because every Finnish resident has a personal identity code. This means that the measuring system has unique personal identifiers to link multiple sources of data- such as episodes of care, visits to doctor or expert nurse, visits to emergency room services, labor input and compensation that currently exists in multiple databases. The possibility of linking the various data sets in this fashion has the potential for creating a holistic view of outcomes and system costs, both direct and indirect, across the entire care-delivery pathway.It is possible to investigate weather investing in preventive care in order to avoid higher treatment costs at later points in value chain. In practice this means for example to invest more in home rehabilitation to keep patients in good condition and then have less service needs in other parts of the pathway. The other example is to invest in a new kind of emergency care model to avoid patient transportation to emergency room services. Also following questions have answers: Do patients/customers come back to other services? Where are customers after certain period of time? What is the service utilization (and costs) of different customer groups and are there any changes? How the customer groups care/service pathways have gone (processes)? Aid in decision making: What are the options and what are the effects (to customer and costs) on longer term. |
format |
Article in Journal/Newspaper |
author |
Itkonen, Pentti Tepponen, Merja Klemola, Katja |
author_facet |
Itkonen, Pentti Tepponen, Merja Klemola, Katja |
author_sort |
Itkonen, Pentti |
title |
Measurement of social- and health outcomes in integrated settings |
title_short |
Measurement of social- and health outcomes in integrated settings |
title_full |
Measurement of social- and health outcomes in integrated settings |
title_fullStr |
Measurement of social- and health outcomes in integrated settings |
title_full_unstemmed |
Measurement of social- and health outcomes in integrated settings |
title_sort |
measurement of social- and health outcomes in integrated settings |
publisher |
Ubiquity Press |
publishDate |
2017 |
url |
https://www.ijic.org/jms/article/view/3624 https://doi.org/10.5334/ijic.3624 |
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karelia* |
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karelia* |
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International Journal of Integrated Care; Vol 17: Annual Conference Supplement 2017; A307 1568-4156 |
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https://www.ijic.org/jms/article/view/3624/4400 10.5334/ijic.3624 https://www.ijic.org/jms/article/view/3624 doi:10.5334/ijic.3624 |
op_rights |
AuthorsStarting in 2009 the International Journal of Integrated Care applies the Creative Commons Attribution 4.0 Internaltional License (CC-by, http://creativecommons.org/licenses/by/4.0/) to all articles, submitted in or after January 2009, that are published in IJIC. Authors retain ownership of the copyright for their articles, but they permit anyone unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. After it has appeared in IJIC authors may republish their text in any way they wish (electronic or print) as long as they clearly acknowledge IJIC as its original publisher with the correct citation details and copyright notice, independent of whether the article is used in whole or in part.Authors of accepted manuscripts assign IJIC the right to publish and distribute their text electronically and to archive it permanently retrievable electronically.Authors retain the copyright of the article. After it has appeared in IJIC authors may republish their text in any way they wish (electronic or print) as long as they clearly acknowledge IJIC as its original publisher with the correct citation details and copyright notice (see below), independent whether the article is used in whole or in part.IJIC may change the appearance of the article, both layout and technical format, to ensure consistency and readability. Under no circumstance will the content of the article be altered.The author warrants to IJIC that the article is original, does not infringe any existing copyright, and does not infringe the rights of any third party. This warrant concerns the entire manuscript, text as well as pictures, sound, video, data sets etc. The author also warrants to us that he has full authority to enter into this agreement and that the rights he is granting to IJIC are done so without breaching any obligations he may have.Acceptation:ReadersStarting 2009 Utrecht the International Journal of Integrated Care applies the Creative |
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CC-BY CC-BY-NC |
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https://doi.org/10.5334/ijic.3624 |
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International Journal of Integrated Care |
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17 |
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5 |
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307 |
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ftjijic:oai:ojs.www.ijic.org:article/3624 2023-05-15T17:00:27+02:00 Measurement of social- and health outcomes in integrated settings Itkonen, Pentti Tepponen, Merja Klemola, Katja 2017-10-17 application/pdf https://www.ijic.org/jms/article/view/3624 https://doi.org/10.5334/ijic.3624 eng eng Ubiquity Press https://www.ijic.org/jms/article/view/3624/4400 10.5334/ijic.3624 https://www.ijic.org/jms/article/view/3624 doi:10.5334/ijic.3624 AuthorsStarting in 2009 the International Journal of Integrated Care applies the Creative Commons Attribution 4.0 Internaltional License (CC-by, http://creativecommons.org/licenses/by/4.0/) to all articles, submitted in or after January 2009, that are published in IJIC. Authors retain ownership of the copyright for their articles, but they permit anyone unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. After it has appeared in IJIC authors may republish their text in any way they wish (electronic or print) as long as they clearly acknowledge IJIC as its original publisher with the correct citation details and copyright notice, independent of whether the article is used in whole or in part.Authors of accepted manuscripts assign IJIC the right to publish and distribute their text electronically and to archive it permanently retrievable electronically.Authors retain the copyright of the article. After it has appeared in IJIC authors may republish their text in any way they wish (electronic or print) as long as they clearly acknowledge IJIC as its original publisher with the correct citation details and copyright notice (see below), independent whether the article is used in whole or in part.IJIC may change the appearance of the article, both layout and technical format, to ensure consistency and readability. Under no circumstance will the content of the article be altered.The author warrants to IJIC that the article is original, does not infringe any existing copyright, and does not infringe the rights of any third party. This warrant concerns the entire manuscript, text as well as pictures, sound, video, data sets etc. The author also warrants to us that he has full authority to enter into this agreement and that the rights he is granting to IJIC are done so without breaching any obligations he may have.Acceptation:ReadersStarting 2009 Utrecht the International Journal of Integrated Care applies the Creative CC-BY CC-BY-NC International Journal of Integrated Care; Vol 17: Annual Conference Supplement 2017; A307 1568-4156 measurement info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 2017 ftjijic https://doi.org/10.5334/ijic.3624 2022-03-22T09:20:09Z This document describes those actions which are the most important to measure the regional system and provide more “out – of – hospital” services as well as some social services. This is due the fact that during recent years we have seen a plethora of new management approaches for improving organizational performance. So far all these approaches in social and healthcare have only meant providing great volumes, measuring and prizing single products, supervising of contracts, controlling and calculating budgets and adding regulation. In spite of that the costs continue to rise at an unsustainable rate in all countries.Social- and healthcare organizations in different countries are focused on costs, not social and health outcomes and values. This calls for a new and more holistic measurement of health outcomes and wellbeing in society and also more understanding of digitalized services. To-day the systems reward those providers, public or private who shift costs and bill for more services, not those providers who deliver the most value. In the care chain the focus is on minimizing the cost for each piece of intervention and limiting services rather than on maximizing value over the entire care cycle. Moreover, without integrated organization structure and comprehensive outcome measurement, it is hard to know what improves value and what does not.The measurement is possible to implement especially in Finland and in South Karelia Social- and Healthcare District (EKSOTE) because every Finnish resident has a personal identity code. This means that the measuring system has unique personal identifiers to link multiple sources of data- such as episodes of care, visits to doctor or expert nurse, visits to emergency room services, labor input and compensation that currently exists in multiple databases. The possibility of linking the various data sets in this fashion has the potential for creating a holistic view of outcomes and system costs, both direct and indirect, across the entire care-delivery pathway.It is possible to investigate weather investing in preventive care in order to avoid higher treatment costs at later points in value chain. In practice this means for example to invest more in home rehabilitation to keep patients in good condition and then have less service needs in other parts of the pathway. The other example is to invest in a new kind of emergency care model to avoid patient transportation to emergency room services. Also following questions have answers: Do patients/customers come back to other services? Where are customers after certain period of time? What is the service utilization (and costs) of different customer groups and are there any changes? How the customer groups care/service pathways have gone (processes)? Aid in decision making: What are the options and what are the effects (to customer and costs) on longer term. Article in Journal/Newspaper karelia* International Journal of Integrated Care (IJIC) International Journal of Integrated Care 17 5 307 |