International Journal of Integrated Care | 2021
A need-based model for defining service packages and chains in health and social care: Early guidelines
Abstract
An introduction In Finland reforming health and social services is deemed necessary because of insufficient coordination of services, problems with availability of services, increasing costs and aging population. This paper outlines a preliminary, generic model for defining and developing service packages and chains in health and social care. It also analyzes the conditions for adopting and applying the model in local environments. Policy context and objective The model is intended to support the local health and social care authorities and public organizers to develop, coordinate and steer the service delivery of public, private and third sector service providers. It has been co-developed during 2018-2019 in dialogic workshops by a network of researchers and health and social care practitioners. Research literature (e.g. segmentation, client profiles) has been utilized in designing the different tasks of defining a service package or chain. The model is person-centered in the sense that even though the service packages and chains are defined on the basis of the pre-identified needs of a citizen/client segments, they function only as integrated frames from which the services of an individual client are co-assembled according to his/her needs.\xa0 Targeted population The targeted population is social and health care clients. The aim is to identify citizen and client segments that will benefit from pre-defined service packages and chains. Highlights Co-development is essential for achieving a workable service package or chain. At least the local service organizers and providers, different professional groups, as well as representatives of citizens/clients should be involved in defining a service package or chain. The definition process itself consists of the following interactive tasks: 1) organizing the co-design activity, 2) analysis of the current state of e.g. service system, demographics and service needs, 3) segmentation of citizens/clients, 4) goal definition for a service package/ chain, 5) modeling a service package/chain, and 6) implementing a service package/chain. Continuous development of a service package/chain consists of three interactive phases which are definition, steering and follow-up. Transferability The model can be adopted and applied in any kind of context of organizing health and social care services, such as, a county, a city and a municipality. It should always be adapted locally by taking into account the local conditions and characteristics. A principal pre-condition for the adoption and application of the model is a citizen/client-centered co-development culture which bases the definition of a service package or chain on the needs of citizen/client groups. As such, it is a tool for a service organizer to ensure and enable person-centered care and support. Conclusions Co-developing integrated services between local practitioners, citizens and clients furthers successful implementation. Splitting the definition process of service packages and chains into well-defined tasks makes the whole easier to manage. To ensure continuous development, the steering and follow-up phases of the model are needed.