At Risk Individuals (ARI) programme, Counties Manukau Health (CMH) Auckland, New Zealand

editor Equipo editorial — 6/02/2017

World Health Organization (WHO)

Problem:

  • Demand for complex care needs among aged and low income populations.
  • Long wait times and frequent emergency visits.
  • Need to adopt a model of care that emphasises on patients achieving long-term behaviour change, while providing care in home settings.

Solution highlights:

  • The model of care provides early and planned interventions, establishes general practice as the centre of coordinated healthcare, provides care based on patient set goals and improves access to a range of specialist and community services.
  • Uses risk profiling as means to identify and judge patient eligibility.
  • Care goals are set and progress overseen by an assigned care coordinator.
  • Funded by flexible regime managed by the providers to ensure care goals can be achieved.

Fragility, pluripathology/polipathology and/or complex chronic diseases

Progress

NEW ZEALAND

Auckland
Practices Map

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