On June 4th we held a new edition – the fifth – of the GestiónAES Stakeholder Workshop entitled “Measuring value and quality of life in the transformation of care”.
The new Lugaritz facilities of the Matia Foundation, in Donostia, San Sebastián, served as the venue for the fifty people who participated. After a brief institutional welcome by me as director of Matia Osasun, we had the opportunity to enjoy a masterful opening speech by the geriatrician Jordi Amblas, Director of the Integrated Care Strategy of Catalonia. Jordi began by arguing about the need to develop truly integrated care, showed the advances in vertical health integration in Catalonia and its evaluations, and ended by talking about the enormous challenge of advancing in social-health integration.
Among the evaluative studies, the “Evaluation of integrated social and health care in the home environment” stood out, showing that the development of a more integrated care reduces the risk of institutionalization in residences by 20%, does not increase overall health expenditure and favors the reduction in social expenditure due to the effect of the decrease in institutionalization. Likewise, comparative information was presented between health areas on the frequency of patients with complex chronicity and advanced disease, where it can be seen how historical OSIs (Integrated Health Organizations) and SSIBE (Integrated Health Organizations)Integrated Health Services of Baix Empordà) achieve very good results. In terms of social and health integration, he commented on the brave decision to fully deploy primary care in residences, assuming that these are the homes of the people who live there and that they must be guaranteed the same quality of care as the rest of the population. This is why primary care teams are responsible for providing for the health needs of residents and responding to them in the same residential centre. He stressed that integrated care is about interaction between professionals and organisations from different areas, not being an end in itself but rather a facilitator of person-centred care.
I ended by paraphrasing Carles Blay saying that “The health and social system of the future will be integrated…or it will not be.” A very clear message for the Policy makers who continue to beat around the bush in this regard.
The first panel of the Workshop entitled “Innovation in care management” then began, where we abused the trust of Jordi Amblás to act as a commentator on the work “Reconciliation of medication at the end of a Psychogeriatric Unit” presented by Adriana San Juan, pharmacist at Matia Osasun, and on the evaluation of the project Etxean Biziby Nerea Etxaniz from the Matia Institute.
Nerea Etxaniz presents her work during the Workshop.
Adriana showed the results of a study on discharge reconciliation, which represents savings by reducing the number of prescriptions/patient, the anticholinergic and sedative load, and the number of patients with reconciliation errors.
For its part, Etxean Bizi It is a complex intervention based on case management aimed at enabling people in need of care to continue living at home if they so wish. The evaluation of the programme shows that social expenditure on home care increases, but residential and health expenditure is significantly lower; in total, 33% less cost in the experimental group.
After the coffee break, the second panel was held on a trendy topic such as Value-based Health Management, with Eduardo Sánchez Iriso from the UPNA as commentator. This panel reflected how the Value-based Health Management movement Value-based healthcare It is making steady progress in some “islands of excellence”, while in most organizations it is neither present nor expected.
Francesc López Seguí from the Management Control Department of Hospital del Mar presented an incipient and exploratory work entitled “The path towards value-based healthcare: first year of PROM and PREM registration in acute hospitalisation”, although it is still early to draw conclusions, some patterns such as the relationship between PROMs and PREMs were really interesting. Next, Borja García-Lorenzo from the Biosistemak Institute presented “Putting the value equation into play as a decision-making tool in value-based healthcare”, in which the practical application of Porter’s value equation for Value-Based Healthcare (VBC) is studied. Borja addressed the ambiguity in the definition of the value of healthcare by proposing a method to estimate patient-centred outcomes while addressing the complexities of cost estimation, with the aim of using the value equation as a tool in decision-making on efficiency in healthcare. This panel concluded with the work “Cost per patient in Value-Based Health Care in Breast Cancer” by Iker Ustarroz from the OSI Ezkerraldea Enkarterri Cruces, where he showed the collaborative work of the VOICE Community and the potential of benchmarking to promote The Value-based healthcare.
Francesc López Seguí presents his work during the Workshop.
And to top it off we had a Short Communications Roundtable, under the title “Caring for the caregiver, the health of informal caregivers” which featured María Errea, director of AEETS, as a commentator on the communications “Does Informal Caregiving Heighten Loneliness? “Exploring the role of anxiety in aging” by Fernanda Juma, PhD student at the UPV/EHU, and “Caring without neglecting oneself: The challenge of mental health in informal caregivers” by Marina Barreda, PhD student at the University of Cantabria.
The Workshop was closed by David Cantarero, Professor at the University of Cantabria and coordinator of GestiónAES, together with Carmen Pérez from the EASP. David reported on the next steps of GestionAES, including the interest group roundtable at the XLIII AES Conference in San Cristóbal de La Laguna and the Workshop in Madrid in October 2024.
