The process of care in integrative health care settings – a qualitative study of US practices

BMC Complementary and Alternative Medicine

Alan Bensoussan¹  Suzanne J Grant¹ 

[1] National Institute of Complementary Medicine, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia

关键词: Complementary and alternative medicine;    Integrated healthcare;    Integrative healthcare;   

Others  :  1085865
DOI  :  10.1186/1472-6882-14-410

 received in 2014-02-05, accepted in 2014-10-07,  发布年份 2014

【 摘 要 】

Background

There is a lack of research on the organisational operations of integrative healthcare (IHC) practices. IHC is a therapeutic strategy integrating conventional and complementary medicine in a shared context to administer individualized treatment. To better understand the process of care in IHC - the way in which patients are triaged and treatment plans are constructed, interviews were conducted with integrative health care leaders and practitioners in the US.

Methods

Semi-structured interviews were conducted with a pragmatic group of fourteen leaders and practitioners from nine different IHC settings. All interviews were conducted face-to-face with the exception of one phone interview. Questions focussed on understanding the “process of care” in an integrative healthcare setting. Deductive categories were formed from the aims of the study, focusing on: organisational structure, processes of care (subcategories: patient intake, treatment and charting, use of guidelines or protocols), prevalent diseases or conditions treated, and the role of research in the organisation. The similarities and differences of the ITH entities emerged from this process.

Results

On an organisational level, conventional and CM services and therapies were co-located in all nine settings. For patients, this means there is more opportunity for ‘seamless care’. Shared information systems enabled easy communication using internal messaging or email systems, and shared patient intake information. But beyond this infrastructure alignment for integrative health care was less supported. There were no use of protocols or guidelines within any centre, no patient monitoring mechanism beyond that which occurred within one-on-one appointments. Joint planning for a patient treatment was typically ad hoc through informal mechanisms. Additional duties typically come at a direct financial cost to fee-for-service practitioners. In contrast, service delivery and the process of care within hospital inpatient services followed a more formalised structure.

Conclusions

IHC is a complex, emerging field with divergent meanings and interpretations. The structures and processes of the IHC entities reported provide insight to the variable ways in which IHC manifests whilst commonly holding a similar vision. This report contributes to understanding IHC, providing evidence for future planning, implementation and evaluation to meet patient needs and demands in this area.

【 授权许可】

   
2014 Grant and Bensoussan; licensee BioMed Central Ltd.

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