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Integrated care may be seen as a response to the fragmented delivery of health and social services being an acknowledged problem in many health systems. [1] [2] [3] This model of care is working towards moving away from a siloed and referral-based format of care to a team-based model.
The clinical pathway concept appeared for the first time at the New England Medical Center (Boston, United States) in 1985, inspired by Karen Zander and Kathleen Bower. [9] [non-primary source needed] Clinical pathways appeared as a result of the adaptation of the documents used in industrial quality management, the standard operating procedures (SOPs), whose goals are:
The medical home, [1] also known as the patient-centered medical home or primary care medical home (PCMH), is a team-based health care delivery model led by a health care provider [2] to provide comprehensive and continuous medical care to patients with a goal to obtain maximal health outcomes.
An integrated delivery system (IDS), also known as integrated delivery network (IDN), is a health system with a goal of logical integration of the delivery (provision) of health care as opposed to a fragmented system or a disorganized lack of system.
Most often, the physicians are paid on a basis of capitation, which in this context means a set amount for each enrolled person assigned to that physician or group of physicians, whether or not that person seeks care. The contract is not usually exclusive so individual doctors or the group may sign contracts with multiple HMOs.
In the United States, an independent practice association (IPA) is an association of independent physicians, or other organizations that contracts with independent care delivery organizations, and provides services to managed care organizations on a negotiated per capita rate, flat retainer fee, or negotiated fee-for-service basis.
The Donabedian model is a conceptual model that provides a framework for examining health services and evaluating quality of health care. [1] According to the model, information about quality of care can be drawn from three categories: "structure", "process", and "outcomes". [ 2 ]
Finally, adherence to the medical model has a number of other consequences for the patient and society as a whole, both positive and negative: In the medical model, the physician was traditionally seen as the expert, and patients were expected to comply with the advice. The physician assumes an authoritarian position in relation to the patient.