London, 6 Sept. 2016
4° ILPN Conference
Social Innovation in “Case Management”:
Lessons from the Italian Long-Term Care
Georgia Casanova, Giovanni Lamura, Andrea Principi
Centre for Socio-Economic Research on Ageing,
National Institute of Health and Science on Ageing (INRCA)
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Aims of presentation:
A. To
illustrate
why
case
management
represents one of the main social innovations
in the Italian context
B. To identify the main policy sectors involved
and the further steps more urgently needed in
the future
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Materials and Methods:
The European research project MOPACT
Mobilising the potential of active ageing in Europe
(MoPAct) Project (2013-2016)
29 partners from 13 countries across Europe to study the
interfaces between the changing demographic profile and its
economic and social impact.
http://mopact.group.shef.ac.uk/
WP8 - Social Support and Long-term Care
Partners from: Austria Estonia, Finland, Germany, Hungary,
Italy, Portugal and Romania.
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Materials and Methods:
Analysis of the Italian Data
QUALITATIVE ANALYSIS
Analysis of
Good
Practices
3 good practices from different regions:
Piedmont: Recognition of informal skills;
Lombardy: Family Nurse Programme;
Marche: UP-TECH project to support caregivers of
Alzheimer’s disease patients
2 focus groups: Milan (North Italy; metropolis); Ancona
(Central Italy; middle city)
Mixed Focus 22 stakeholders involved: Local institutions (Regions
Groups
and Municipalities), Non-profit & Profit organizations;
Trade Unions; Foundations; Private companies and ITC
industries; Research agencies
Expert
Interviews
7 experts involved: National Experts; Experts from
Southern regions; Coordinators of analyzed good
practices
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Definition of Social Innovation (SI)
“Social Innovation” is defined as any new idea
(including products, services and models) that
simultaneously meets social needs (more
effectively than alternatives) and creates new
social relationships or collaborations, i.e. it is
both good for society and enhances society’s
capacity to act (European Commission, 2013).
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Social Innovations in Italian LTC
Social Innovations
Description and comments
Already implemented at local level:
Integrated mixed services
to support "family care &
private care workers”
System of services providing support to
management of carers for each specific case.
Matching D/O.
Case management
As a strategy of integration of services;
as strategy to build a personalized care
path. Public or for profit experiences exist
Genuine admittance
“Taking true cases in charge”: Experiences
exist especially for specific areas (dementia)
Ideas for the future:
Proactive prevention
Prevention activities to contrast becoming
dependent; Support services to older people
without dependency
Educating about
dependency
Prevention as an issue to be approached
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during the whole life course; Promoting the
idea that older age is part of life.
Results on Case management (1)
Case management is seen as an important strategy to
“integrate care services” and to “build a personalized care
path”.
Case management is one of the social innovations “already
implemented” at local level, but only in limited areas.
Existing experiences promote an idea of public governance
for case management (“Up-tech” case study), but also private
(“Family nurse” experience).
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Results on Case management (2)
Barriers & drivers:
Bureaucracy is one of the main barriers, as it continues to
separate health & social care (in terms of funding,
organisation etc.).
The “national LTC fund” was an existing driver, as it
stimulated integration and could be used to promote the
implementation of "case management" nation-wide.
Case management involves four main policy areas:
a. Integration & coordination;
b. Expansion of services;
c. Support to users and informal carers;
d. Shifting the 'ageing' paradigm.
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Social Innovations & Policy areas
Integration
Expansion
of services
Support
carers
Shifting
Ageing
paradigm
Case
management
x
x
x
x
Integrated
mixed services
"family care &
care workers”
x
x
Genuine
admittance
x
Proactive
prevention
x
Educating
about
dependency
x
x
x
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x
x
Results focused on Case management in
crossing Social Innovations and Policy Areas
 Case management as social innovation underlines the
need for a strategy focused on “multi-level integration” and
“user- centered” (as confirmed also by the relationship
between all social innovations).
Case management idea supports the “shifting the 'ageing'
paradigm” as well as social innovations for the future
(Proactive prevention and Educating about dependency).
Case management promotes an open idea of expansion of
services linked to new typologies of services for new targetusers (namely, users of prevention services and care
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workers).
Conclusions
Case management should not necessarily be defined as
only “a professional management tool”:
The implementation of case management is futuroriented:
 to promote multi-level integration strategy.
 to improve the quality of care provided.
 to improve the quality of life of older people.
 to support the “shifting the 'ageing' paradigm”.
 to promote social innovation in LTC.
Specific policy recommendations adopt this “open
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meaning”.
Policy recommendations to improve nation-wide
case management in Italy
 Facilitate the transferability of experiences, also to support
the federation and joint collaboration of micro-level initiatives
into meso and macro level networks;
 Disseminate ICT use, as it is a key-driver to improve
quality of care and working conditions;
 Promote the inter-professional, inter-institutional and interstakeholders collaboration;
 Promote the development and strengthening of an LTC
system identity, that includes prevention as a relevant
component.
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Grazie per l’attenzione!
Thanks for your attention!
Georgia Casanova
E-mail: [email protected]
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