Book Review
Integrating Health and Social Care Services for Older Persons: Evidence from Nine European Countries (Public Policy and Social Welfare)
Jenny Billings and Kai Leichsenring (eds)
ISBN: 978-0754644736; 2005; 345 pages; Ashgate Publishing, Hampshire;
Lenore Beddoes
PhD Candidate, Alfred-Deakin Nursing Research Centre, The Alfred Hospital/Deakin University, Melbourne VIC
Developing and working within health and social care systems that facilitate supportive care for older people is on the international agenda for health service providers and policy makers. This text describes the European ‘Providing Integrated Health and Social Care for Older People' (PROCARE) project. It is the second in a series that explores integrated long term care in nine European countries. PROCARE was funded by the European Commission and undertaken from April 2004 to February 2005 with the aim of searching for ways of overcoming problems at the interface between health and social care systems to increase the quality of life for everyone involved in this process.
The book begins with an overview and rationale for the PROCARE project and the 18 model ways of working that are explored by the authors of the ensuing chapters. The subsequent seven chapters provide definitions of key terms and describe: issues of access to integrated care; the notion of inter-professional collaboration; the methodological (case study) approach; the different perspectives of key stakeholders (users, family caregivers and the multi-professional team); outcomes and benefits of integrated care; and an overview of the working conditions of staff in the model programs.
Person-centred holistic care is a central theme referred to in the 18 exemplary models and is portrayed as promoting the autonomy, integrity and dignity of clients. In chapter six, impediments to achieving integrated care and program outcomes such as user and carer satisfaction, changes in functional status, psychological state and social connectedness are presented. There is room for further exploration of user and carer outcomes in future research and it is encouraging to note these generally positive preliminary outcomes from the PROCARE project.
Chapter seven provides a description of the roles and working conditions of the multi-professional groups who implement the various models of care. While social workers took a leading role in many programs, nurses were found to be the most commonly involved professional group, working in 15 of the 18 models described. The specific roles of the nurses varied, but are described as pivotal in discharge management and care or case management functions. Findings of both positive and negative aspects of the working conditions within the models of integrated care are reported in this chapter and it is worth exploring this book, irrespective of the contextual differences, because intuitively similar issues could be experienced, and perhaps avoided, in other countries.
PROCARE is a large research undertaking and the case studies presented in this book offer insight into how the models of integrated care impact users, carers and health professionals. Moreover, this book enables consideration of existing Europeans models and provides food for thought when considering possible strategies to improve the quality of care provided to older people at the interface between the health and social care systems in the Australian context.
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