Suchergebnisse

La Health Literacy (HL) se définit comme 'la connaissance, la motivation et les compétences des individus à accéder, comprendre, évaluer et appliquer l'information en matière de santé en vue de porter des jugements et de prendre des décisions de tous les jours en ce qui concerne la santé, la prévention des maladies et la promotion de la santé, de manière à maintenir ou améliorer la qualité de vie'. Au niveau politique belge, ce concept commence à être reconnu comme étant un domaine d'action prioritaire. En effet, une HL limitée peut affecter la santé en conduisant, par exemple, à une moins bonne gestion des maladies chroniques, à davantage d'hospitalisations et de décès prématurés. Cet article aborde la question de l'évaluation de la HL, des interventions pour l'améliorer ainsi que les nombreux défis qui restent à relever dans ce domaine. La HL semblerait fondamentale pour le développement d'une meilleure gestion de la santé. Elle permettrait au patient de jouer un rôle plus actif dans la prise en charge de sa santé, de responsabiliser tous les acteurs de la santé, et de contribuer à un système de santé plus viable. Améliorer la HL devrait permettre une meilleure égalité d'accès aux soins de santé. ; Health literacy (HL) is defined as 'the knowledge, motivation, and competences to access, understand, appraise and apply health information in order to make judgments and take decisions in everyday life concerning health care, disease prevention and health promotion to maintain or improve quality of life'. This concept begins to be recognized as a priority area for action at political level in Belgium. Indeed, a limited HL may affect health by leading, by example, with poorer management of chronic diseases, more hospital admissions and premature deaths. This paper addresses the question of HL evaluation, improvement interventions as well as the many challenges that remain in this area. HL seems fundamental to the development of better health management. It would allow patients to play a more active role in health care, to involve all health stakeholders, and to contribute to a more sustainable health system. Improving HL could allow better equal access to health care. ; Peer reviewed

Background: The twelve Integrated Care Program pilot projects (ICPs) created by the government plan 'Integrated Care for Better Health' aim to achieve four outcome types (the Quadruple Aim) for people with chronic diseases in Belgium: improved population health, improved patient and provider experiences and improved cost efficiency. The aim of this article is to present the development of a mixed methods realist evaluation of this large-scale, whole system change programme. Methods: A scientific team was commissioned to co-design and implement an evaluation protocol in close collaboration with the government, the ICPs and several other involved stakeholders. Results: A protocol for a mixed methods realist evaluation was developed to gain insights into the mechanisms that foster successful results in ICPs. The qualitative evaluation proposed will be based on the document analysis of yearly ICP progress reports, selected case studies and focus group interviews with stakeholders. Processes and outcomes of all the projects will be monitored using indicators based on administrative data on population health and the quality and costs of care. A yearly survey will be organized to collect data on patient-reported outcomes and experiences and on provider-reported measures of inter-professional collaboration and proper wellbeing. Using both quantitative and qualitative data, we will develop theories about the mechanisms and the associated contextual factors that lead to integrated care and the Quadruple Aim outcomes. Discussion: The objective of this study is to deliver policy recommendations on strategies and best practices to improve care integration in Belgium and to implement a sustainable monitoring system that serves both policy makers and the stakeholders within the ICPs. Some challenges due to the large scale of the project and the multiple stakeholders involved may impede the successful implementation of this proposal. ; Peer reviewed