Patient-centered approach and new public management: confluence and paradox

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The search for efficiency and concentration on patient needs and satisfaction are at the heart of current approaches in terms of service quality [21, 42], collaboration and multi-professional and multidisciplinary coordination [18]. Indeed, the diffusion of integrative approaches marks the evolution of the health system in Japan as in all Western countries (eg new coordination professions [2], new socio-technical devices [17]). This phenomenon is due in particular to the demographic and epidemiological transition that is leading to an increase in the number of patients suffering from chronic diseases requiring comprehensive, continuous and multidimensional care. Two principles constitute the pillars of these new approaches to care

The patient-centered care: principles and contributions

Very different from institutions¬†deep tissue massage las vegas¬† or services-centered approaches, so-called “person-centered or patient-centered” approaches have been developed for the case of chronic patients. Indeed, if acute diseases represent a temporary break with lifestyle, chronic diseases mean a permanent loss of the previous condition [43] and require ongoing management to prevent or delay the deterioration of the disease. state of health of the patient. Also, the search for a better quality of care requires taking into account the clinical particularities of each patient, as well as the integration of their specific needs. The solutions proposed must, therefore, take into account several dimensions relating to both the situation of each person (socio-economically),.

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Service integration and its conceptual models

The integration of services is carried out as close as possible to the chronic patient through professional practices that allow the coordination of the clinical, normative and structural components of an inherently complex service offer. Such an integration project requires the development of innovative mechanisms and tools to be concretely mobilized by professional actors. Integration, therefore, requires a series of strategies, approaches, and methods that support service coordination and interprofessional collaboration to enhance the quality of care and services,, as well as patient satisfaction.

Service integration schemes must, therefore, concern both the clinical aspect of any professional practice and the organizational aspect of any complex intervention [15, 73-74]. The purpose of the coordination that results from this can not be reduced to the clinical dimension, either the professional acts performed for a patient, or the organizational dimension alone, ie the norms and rules of the institution, the organized labor and distribution of resources

Continuity of services (information continuity, relational and approach around the patient (management continuity), concerns the clinical coherence of the various interventions carried out in the patient’s situation