Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care

Primary care is essential to the effective and efficient functioning of health care delivery systems, yet there is an impending crisis in the field due in part to a dysfunctional payment system. We present a fundamentally new model of payment for primary care, replacing encounter-based imbursement with comprehensive payment for comprehensive care. Unlike former iterations of primary care capitation (which simply bundled inadequate fee-for-service payments), our comprehensive payment model represents new investment in adult primary care, with substantial increases in payment over current levels. The comprehensive payment is directed to practices to include support for the modern systems and teams essential to the delivery of comprehensive, coordinated care. Income to primary physicians is increased commensurate with the high level of responsibility expected. To ensure optimal allocation of resources and the rewarding of desired outcomes, the comprehensive payment is needs/risk-adjusted and performance-based. Our model establishes a new social contract with the primary care community, substantially increasing payment in return for achieving important societal health system goals, including improved accessibility, quality, safety, and efficiency. Attainment of these goals should help offset and justify the costs of the investment. Field tests of this and other new models of payment for primary care are urgently needed

Differences between immigrant and non-immigrant groups in the use of primary medical care; a systematic review

Background. Studies on differences between immigrant and non-immigrant groups in health care utilization vary with respect to the extent and direction of differences in use. Therefore, our study aimed to provide a systematic overview of the existing research on differences in primary care utilization between immigrant groups and the majority population. Methods. For this review PubMed, PsycInfo, Cinahl, Sociofile, Web of Science and Current Contents were consulted. Study selection and quality assessment was performed using a predefined protocol by 2 reviewers independently of each other. Only original, quantitative, peer-reviewed papers were taken into account. To account for this hierarchical structure, logistic multilevel analyses were performed to examine the extent to which differences are found across countries and immigrant groups. Differences in primary care use were related to study characteristics, strength of the primary care system and methodological quality. Results. A total of 37 studies from 7 countries met all inclusion criteria. Remarkably, studies performed within the US more often reported a significant lower use among immigrant groups as compared to the majority population than the other countries. As studies scored higher on methodological quality, the likelihood of reporting significant differences increased. Adjustment for health status and use of culture-/language-adjusted procedures during the data

Collective Impact Partnership and Backbone Organizations as Enablers of Children’s Well-Being

In this article, the question of partnership is approached from a perspective centred around the creation of a common agenda based on trust and from the children´s point of view. Partnership and collaboration have traditionally been viewed as mechanisms to create bridges between organisations and institutions from the private, public and non-governmental sectors in order to enhance funder collaboratives, public-private partnerships, multi-stakeholder initiatives, social sector networks and collective impact initiatives. It was not however until Kania and Kramer´s (2011) seminal work on collective impact when this subject came to be viewed as a developmental process aiming at the creation of a common agenda and mutually agreed activities and consisting of five integral parts: a common agenda, shared measurement systems, mutually reinforcing activities, continuous communication and backbone support organisations. This article, based on a systematic review of the topic, maintains that partnership – approached from the point of view of children and through the lens of collective impact – constitutes a crucial mechanism in the creation of safe and comprehensive wellbeing for children. Thus, this article – using Kania and Kramer´s (2011) definition of collective impact and focusing on the structure of partnerships and the nature of trust in organisations as the prerequisite for partnership – advocates the importance of the UN SDG17 principle as the bringer of inclusive society built upon principles and values, a shared vision, and shared goals that place people at the centre of human endeavour.© Springer Nature Switzerland AG 2020. This is a post-peer-review, pre-copyedit version of an article published in Partnerships for the Goals. Encyclopedia of the UN Sustainable Development Goals. The final authenticated version is available online at: http://dx.doi.org/10.1007/978-3-319-71067-9_111-1.fi=vertaisarvioitu|en=peerReviewed