Key messages

• Making care focus on patients is a way of overcoming the fragmentation that results from the “disease orientation” of Europe’s health systems, which still tend to organize around single medical specialities.
• Patient-centredness increases patient satisfaction and counters the problems associated with fragmented care, such as contradictory medical advice, over prescribing, over hospitalization and unresponsiveness.
• Patient-centredness requires a coordinated approach to the organization and delivery of care (and works well with integrated care initiatives).
• Innovative patient-centred programmes have often been grassroots initiatives that have come about despite, not because of, national regulations.
• Policy makers can foster innovation and effective collaboration by creating a supportive policy, regulatory and financial environment.
• Policy makers need to address blocks to patient-centerdness at the micro, meso and macro levels and can do this by:
  • Providing training for patients and professionals and making health information accessible including through eHealth tools (micro or individual level action)
  • Developing a shared vision of patient-centredness and assigning responsibility for coordination and for fostering links between sectors (meso or organization level action)
  • Ensuring monitoring and quality measurement reflect expectations and by tackling legislative and regulatory blocks to patient centredness (macro or system level initiatives).
• Decision makers might also consider other evidence informed measures including:
  • ‘Care coordinator’ roles – creating focal points for people with multimorbidity
  • Patient-relevant outcome indicators – ensuring performance measurement systems assess more than clinical or functional outcomes
  • Actively promoting collaboration with social care, patient organizations and carers
  • Shaping process and outcome evaluations so that the review of new approaches to patient-centred care identifies the contextual factors that contribute to their success and impact.

Contents

• What is ICARE4EU?
• How do Policy Briefs bring the evidence together?
• Acronyms
• Key terms
• Executive summary
• Policy brief
  • Introduction
  • Findings
  • Discussion
  • Conclusions
• References
• Appendix 1. Rapid review of the literature
• Appendix 2. Selection of innovative approaches in European countries by the ICARE4EU project
• ICARE4EU Policy Briefs

This report arises from the Innovating care for people with multiple chronic conditions in Europe (ICARE4EU) project, which has received funding from the European Union (EU), in the framework of the Health Programme. The authors wish to thank all country expert organizations and the programmes that participated in the ICARE4EU project. The authors are grateful to the programme managers for sharing information on their programmes.

The authors and editors are also grateful to Isabelle Scholl (University of Hamburg) and to Hans Bart (Dutch Kidney Patient Association) for reviewing this publication and contributing their expertise.

All rights reserved. NIVEL and TU Berlin have granted the European Observatory on Health Systems and Policies permission for the reproduction of this Policy Brief.

The content of this Policy Brief represents the views of the authors only and is their sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.

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What is a Policy Brief?