First findings: WP1 preliminary results

About the Project

In order to realize person-centred, integrated long-term care (PC-I-LTC) in the countries of the European Union, it is necessary that the framework conditions that characterize PC-I-LTC are known and coordinated. Only in this way can the specific needs of the individual countries be adequately identified and adapted and realized through targeted measures.

Within the BUILD project, person-centred care is the central guiding element. Numerous indicators were identified that are relevant and decisive with regard to person-centred care. Different levels of consideration were identified that need to be taken into account in the various settings: Shared decision-making, mutual respect, dignity and respect for personality are some of the important core elements of person-centred care. Another key aspect to consider is the existing health inequality, e.g. due to gender, place of residence or socio-economic status, which manifests itself in an unequal distribution of resources and unequal health conditions.  In order to avoid overuse, underuse or misuse, these differences can be specifically addressed through person-centred approaches with needs-based services. Technological solutions play a key role in this. They enable improved access to care, increase the quality of care and promote continuous, coordinated care. In this way, technology supports person-centredness as a guiding principle and can simultaneously contribute to reducing health inequalities.

In addition, numerous factors could be identified and structured that are relevant to and characterize the ecosystem in the context of PC-I LTC. These can initially be differentiated into external and internal factors, which in particular represent the external framework conditions of the ecosystem and outline their intersections as well as the way in which the individual actors involved (inter)act with each other. In particular, regulatory frameworks, social norms and digital infrastructures are key elements that were identified in the context of external factors. At an internal level, organizational structures, communication and existing relationships between stakeholders are particularly relevant. In the context of an ecosystem for PC-I LTC and using the SROI (Social Return on Investment) method, impact chains can be described as a central instrument for measuring and evaluating the social, environmental and economic impact of the supply system. These impact chains provide a systematic representation of the inputs, activities, outputs, outcomes and impacts that result from the provision of person-centred, integrated long-term care. SROI’s strengths include its societal perspective and its ability to capture outcomes that matter to multiple stakeholders, such as care recipients, formal and informal caregivers, and healthcare systems. However, challenges persist in developing a robust evidence base. Data gaps for outcome measurement, the absence of control groups, and difficulties in generalizing findings due to inconsistencies in outcome measures and monetary proxies are notable limitations. Addressing these limitations, future research could expand SROI applications to more varied contexts and refine financial proxies to reflect the local realities of care better.

Authors: Alisa Bader, Sebastian Schmidt, Susana Ramalho Marques, Amrei Mehler-Klamt, Michaela Schneider