Many countries and health systems are pursuing integrated care as a means of achieving better outcomes. However, no standard approaches exist for comparing integration approaches across models or settings, and for evaluating whether the key components of integrated care are present in different initiatives. This study sheds light on how integrated care is being implemented in Australia, using a new tool to characterise and compare integration strategies at micro, meso and macro levels. In total, 114 staff from a purposive sample of 38 integrated care projects completed a survey based on the Rainbow Model of Integrated Care. Ten key informants gave follow-up interviews. Participating projects reported using multiple strategies to implement integrated care, but descriptions of implementation were often inconsistent. Micro-level strategies, including clinical-professional service coordination and person-centred care, were most commonly reported. A common vision was often described as an essential foundation for joint work. However, performance feedback appeared under-utilised, as did strategies requiring macro-level action such as data linkages or payment reform. The results suggest that current integrated care efforts are unevenly weighted towards micro-level strategies. Increased attention to macro-level strategies may be warranted in order to accelerate progress and sustain integrated care in Australia.
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Dit wetenschappelijke boek van Wilkinson & Pickett onderzoekt de desastreuze maatschappelijke gevolgen van een toenemende inkomensongelijkheid.
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Rationale/Purpose: High-performance sport systems offer athletes access to a range of experts including excellent coaches. This study examines the macro-, meso- and micro-level factors associated with coaching elite women athletes within a high-performance sport system. Design/methodology/approach: This research was underpinned by constructionism and critical feminism. The data were collected via semi-structured in-depth interviews with 10 international male elite rowing coaches with experience in coaching men and women athletes and analysed using thematic analysis. Findings: The data shows that at the micro-level, coaches differentiate their practices based on the gender of the athlete. These practices are influenced by meso-level factors (perceived value of sport participated by women) and shaped by macro-level factors (socio-cultural background of the coaches). Practical implications: Coaches’ socio-cultural experiences influence their construct of gender and affect their approach to coaching women athletes. Hence identifying macro-level factors can help managers understand coaches’ perspectives, philosophy and practice at a micro-level. https://doi.org/10.1080/23750472.2019.1641139 LinkedIn: https://www.linkedin.com/in/donna-de-haan/
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