Search

The opening up of green spaces could provide significant benefits to society. This study develops a framework to assess the economic benefits and costs of public interventions providing citizen access to urban green spaces. The Thinking Fadura project in Getxo (Spain) was used as a case study. A method for participatory benefit-cost analysis is developed, where a stakeholder-participatory evaluation is combined with a standard cost-benefit analysis. The participatory evaluation followed a bottom-up approach in a sequential evaluation including three main focal points: key stakeholders and experts, visitors and the general public. The assessment demonstrates that the Thinking Fadura project&rsquo, s benefits outweigh the costs. The results suggest that projects designed with the purpose of improving green space accessibility to the general public can be beneficial from a societal perspective. The highest economic benefits were an increase in the amenity and recreational value and an increase in people&rsquo, s physical activity. The participatory evaluation indicates that giving access to people of lower socio-economic status and vulnerable groups and improving recreational use were perceived as the most beneficial. An increase in noise, dirt, and risk of criminal activities as well as potential conflicts between green space users were perceived as the most negative impacts of opening a previously restricted area to the general public. The economic assessment of Thinking Fadura project could serve as a model in the decision-making process in locations where the use of greenspaces is restricted.

Introduction: The establishment of a common language and the start up of the future clinical and social shared record has emerged as priorities in Health and Social (H&S) care strategy for Euskadi 2013-2016.After assessing different European tools, it has been chosen InterRAI-CA. The implementation of InterRAI-CA has taken place thanks to a research project funded by Etorbizi, which outcomes (presented in 2014), shows that this is a powerful and effective tool for the development of a common H&S language. This tool also allows obtaining products shared by both healthcare areas: health and social.This instrument has been presented as an interagency project to the Health and Social Care Basque Council as the embryo of a future project of the clinical and social shared records, based on its capabilities to gather H&S common and proven information and to develop individualized care plans.Short description of the practice: The deployment of the tool has an interagency and multidisciplinary scope: 70 users distributed among the three Basque Foral institutions (provincial councils), primary care centers, hospitals emergency, and municipalities of the 3 provinces. It has been realized training session to the professionals involved (doctors, nurses and social workers). Additionally, there are RAI tutors who have been appointed in each organization to facilitate the implementation and use of the tool.The RAI assessment applies when the H&S care professional detects a case of H&S intervention, preferably in regards to the group of elderly people in a situation of dependency. The result will be contrasted systematically between H&S primary care teams (sent by email). The result of the assessment includes the H&S diagnosis and the first Individualized Care Plan.Finally, the H&S team should meet to validate or improve the care plan and, after that to review and follow-up the case.Goals:• To promote the presence of interoperability tools in the health and social context.• To ensure the training of trainers in these tools.• To stimulate the H&S primary care teams based on the development of protocols that use the InterRAI-CA as an element of communication.• To evaluate the performance of InterRAI-CA and implement corrective measures.Outcomes: The project ends in November 2016. The activity of the deployment has a set of performance indicators related to: the number of training sessions, the number of users from different organizations trained; the number of H&S cases evaluated and the number of H&S care plans, among others.The expected outcomes seek to validate the tool between both health and social professionals, and to provide context to extend its use to all the Basque Country. It also aims to establish a common language, which promotes the interoperability between H&S systems and progress in the future clinical and social shared record.

Policy developments : There is consensus among experts assert that the system of social health provision is fragmented, users will be those who suffer the consequences, and that we must provide better coordinated and integrated socio-services model. In Euskadi, with great institutional experience in geriatric care, there is a Basque Council of geriatric care, whose purpose is the guidance and monitoring of policy decisions, regulatory, economic, organizational and care, in terms of care coordination. In July 2013, the Basque Council of geriatric care (CVASS) approved five Strategic Lines (L.E.) for 2013-2016. The document that collects, includes a review of the concept of geriatric care, calling complex construct. The L.E. reinforce the strategic approach model of coordination between sectors, which does not prevent progress, when necessary, to integrated health and social care provision. Also the strategic lines of the Basque health service OSAKIDETZA, provide "Advance the Implementation and Consolidation of Clinical Information System Unified" with actions to integrate the systems of healthcare information among different health care settings and social partners, to promote continuity of care under the same process. Introduction : For our project, we focus on L.E-2: "System Implementation Information and Communication Sociosanitario". This line aims to avoid the fragmentation of information and the difficulties of accessibility to enable more equitable benefits and improve continuity of care and attention, people integrated into the Sociosanitario space. In 2012, Euskadi had a population> 65 years of 431,460 people, there 17746 residential places. Of these, 3735 with Osakidetza doctor and squares 14011 (80.48%), with other medical institutions without access to clinical data Osabide history. We also find residences that have different clinical information systems not compatible with H. C. Osabide, Osakidetza and offline with the electronic prescription. Objective : Piloting and deploy the Osabide medical history, Residences, responding to an approach focused on three elements: Person: Security, Privacy, comfort, satisfaction and continuity of care. Professional: Agility, Communication, Collaboration, Coordination and Feedback. Institutions: Coordination, agreements, consensus, communication and interoperability. METHODOLOGY: Project Management Methodology was used. The project was divided into several phases, with different solutions: - Phase I: CLINIC (medical history viewer) - Phase II: CLINIC + PRESBIDE (universal electronic prescribing system) - Phase III: GLOBAL Osabide (unified medical record) + PRESBIDE - Pass IV: GLOBAL Osabide + PRESBIDE + OSANAIA (clinical nursing station) Public Residences, concerted Private residences, both with / without medical Osakidetza: Inclusion criteria were defined. the type of units of each residence, number and profile of residents, professionals, existing healthcare information system was assessed. proposal for piloting, which approved the CVASS was developed. Results : - Piloting in 19 Residences (07-2014_06-2015): 4 in Araba, Bizkaia 9 and 6 in Gipuzkoa - Professional Training. - Obtaining indicators - Impact: reach 2122 residential places (12%) - Detection enhancements for subsequent deployment - Approach deployment. Target 2015: exceed 30% range in residential places. Lessons learned / improvements to mainstream :PRESBIDE achieve interoperability with information systems Residences: Resiplus, SIGECA, Others, ... Residences allow the connection to the public computer network "EUSKAL SAREA". Implement other features on-line (Interconsultations, RX and analytical requests, ...). Improve the involvement of professionals and Institutions Enable access to other professionals involved in the P.A.I. Objectives Integration incorporate clinical information systems, through concerts and Contracts Program. Conclusions : - The pilot of this project has detected improvements over Information System and Inter-agency coordination (Meso level). - Access to the HC Osabide, an improvement of Integrated Management, both in diagnostic activity, treatment and monitoring of institutionalized Residential users, achieving improvements in safety. - Improved interagency coordination, information sharing systems. - Allows benefit from synergies and opportunities for coordination and improved health integration. - Progress was objectified in the development of geriatric space, at the micro level.