Suchergebnisse

Background  Ongoing deinstitutionalization has resulted in several problems in medical care delivery to people with intellectual disability, such as an increased workload for general practitioners (GPs) and a lack of active co‐ordination and co‐operation between healthcare professionals. A major consequence is the incidence of untreated yet treatable medical conditions. An integrated care approach may provide a means for better co‐ordination and delivery of care. The aim is to review recent integrated care initiatives and their significance for people with intellectual disability.Method  A literature search was conducted to trace relevant literature on integrated care for people with intellectual disability published between 1995 and 2003.Results  Although integrated care appears to offer potential for eliminating fragmentation and discontinuity in medical care for people with intellectual disability and for reducing GP workload, there are few published studies which have evaluated its implementation with people with intellectual disability.Conclusions  Even though the potential advantages of integrated care are well known, the applicability of this approach for people with intellectual disability has still to be demonstrated.

Adolescent sexual and reproductive health and rights (SRHR) are of particular relevance given their potential short-term or long-term health consequences. This study evaluates recommendations and policies regarding access to care in this area in 31 European countries (European Union (EU) plus Iceland, Norway and Switzerland). As part of the EU funded Models of Child Health Appraised project, data were gathered using a 43-item questionnaire sent to experts responsible for collecting information in each country. Ten countries have not developed any formal policy or recommendation that guarantee the respect of confidentiality and the possibility of consulting a physician without parents knowing. Nearly half of the countries do not have centres specialised in adolescent healthcare, tackling comprehensive health issues or focusing specifically on SRH. Access to emergency contraception and information regarding pregnancy, including testing, is easy in most countries. However, oral contraception is delivered free of charge in only 10 countries. Twenty-three countries do not meet current standards in terms of providing policy-based pregnancy care, and only 13 have set up special programmes for pregnant adolescents. In only seven countries can adolescents definitely have their pregnancy terminated without their parents knowing (and in another seven countries in selected situations). The provision and availability of adolescent-friendly SRHR care are far from optimal in around half of the surveyed countries. These results call for the review and implementation of policies, specialised healthcare centres and training initiatives for primary care providers.