TY - JOUR
T1 - Exploring New Models for Implementing Sustainable Integrated Health Access for People in Vulnerable Positions
T2 - Protocol for a Mixed Methods Multiple Case Study
AU - Mejsner, Sofie Buch
AU - Aslaug, Jane
AU - Bech, Mickael
AU - Burau, Viola
AU - Mark, Dorte
AU - Vixø, Kathrine
AU - Westergaard, Caroline Louise
AU - Fehsenfeld, Michael
N1 - ©Sofie Buch Mejsner, Jane Aslaug, Mickael Bech, Viola Burau, Dorte Mark, Kathrine Vixø, Caroline Louise Westergaard, Michael Fehsenfeld. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 23.08.2024.
PY - 2024/8/23
Y1 - 2024/8/23
N2 - Background: Health care is a strongly universal right across European welfare states; however, social inequalities in health persist. This literature argues that health care organization is an important but overlooked determinant of social inequalities in health, as health systems buffer or amplify structural and individual health determinants. The Client-Centered Coordination Platform (3CP) model offers integrated health access to people with severe mental illness, through core groups of professionals from across health and social services. Objective: This study focuses on vulnerable people with severe mental health problems and aims to analyze how the model can give people with severe mental illness more integrated access to health and social care. This can form a stepping-stone for the upscaling of the 3CP model. Methods: We conduct a 5-year multiple case study of 3 municipalities in Denmark, where 3CP is being implemented. In a 1-year pilot study, we expect to gather quantitative registry data from the municipalities and the Central Denmark Region to explore the characteristics of people included in 3CP. We will also collect qualitative data, including 21 hours of observations; 36 interviews with users, professionals, and managers; and 3 focus groups across the 3 municipalities. In a subsequent, 4-year qualitative study, we aim to conduct 120 hours of observations, 120 interviews, and 24 focus groups. In parallel with the qualitative study, we will facilitate a cocreation process to develop tools for sustaining integrated health access. Results: As of January 2024, we have completed the individual interviews with users of 3CP and professionals and the focus groups. Individual interviews of managers will be conducted during the 1st quarter of 2024. The quantitative data are being collected. Conclusions: Inequality is one of the greatest challenges that European societies face. Understanding new and innovative approaches to integrated care may provide valuable solutions to the challenges posed. Especially understanding and designing health and social care systems that meet the needs and abilities of those users requiring them most, is vitally important to tackle inequality.
AB - Background: Health care is a strongly universal right across European welfare states; however, social inequalities in health persist. This literature argues that health care organization is an important but overlooked determinant of social inequalities in health, as health systems buffer or amplify structural and individual health determinants. The Client-Centered Coordination Platform (3CP) model offers integrated health access to people with severe mental illness, through core groups of professionals from across health and social services. Objective: This study focuses on vulnerable people with severe mental health problems and aims to analyze how the model can give people with severe mental illness more integrated access to health and social care. This can form a stepping-stone for the upscaling of the 3CP model. Methods: We conduct a 5-year multiple case study of 3 municipalities in Denmark, where 3CP is being implemented. In a 1-year pilot study, we expect to gather quantitative registry data from the municipalities and the Central Denmark Region to explore the characteristics of people included in 3CP. We will also collect qualitative data, including 21 hours of observations; 36 interviews with users, professionals, and managers; and 3 focus groups across the 3 municipalities. In a subsequent, 4-year qualitative study, we aim to conduct 120 hours of observations, 120 interviews, and 24 focus groups. In parallel with the qualitative study, we will facilitate a cocreation process to develop tools for sustaining integrated health access. Results: As of January 2024, we have completed the individual interviews with users of 3CP and professionals and the focus groups. Individual interviews of managers will be conducted during the 1st quarter of 2024. The quantitative data are being collected. Conclusions: Inequality is one of the greatest challenges that European societies face. Understanding new and innovative approaches to integrated care may provide valuable solutions to the challenges posed. Especially understanding and designing health and social care systems that meet the needs and abilities of those users requiring them most, is vitally important to tackle inequality.
KW - Delivery of Health Care, Integrated/organization & administration
KW - Denmark
KW - Focus Groups
KW - Health Services Accessibility/organization & administration
KW - Humans
KW - Mental Disorders/therapy
KW - Pilot Projects
KW - Qualitative Research
KW - Vulnerable Populations
KW - vulnerable people
KW - mental illness
KW - accessibility
KW - Europe
KW - healthcare access
KW - integrated health access
KW - healthcare
KW - inequality
KW - health inequalities
KW - social inequalities
KW - social inequality in health
KW - health care organization
UR - http://www.scopus.com/inward/record.url?scp=85202198221&partnerID=8YFLogxK
U2 - 10.2196/56197
DO - 10.2196/56197
M3 - Journal article
C2 - 39178409
SN - 1929-0748
VL - 13
SP - e56197
JO - JMIR Research Protocols
JF - JMIR Research Protocols
M1 - e56197
ER -