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Integrated health and social care services in Pardubice region (AZASS)

Summary of the good practice:

General and specific objectives of the practice is to provide holistic set of support/care/services (health and social care) tailored to the needs of people with reduced self-sufficiency due to illness, disability or frailty and to support their carers so that they can stay at home or in their community as long as possible. It includes close interdisciplinary cooperation within AZASS facilities and services (post-acute and long-term care hospital, primary care physicians/specialists, social rehabilitation and occupational therapy as well as home care, respite and residential services for elderly and housing) to assure person centred and continuous support to those in need in the region.

Main methods, processes and organisation.

The services operate through Association of all local/regional municipalities that joined together to create association of 27 municipalities “AZASS” to share decisions, strategy, property and services. The structure was designed to assure stability, subsidiarity, democracy and to face instability of political cycle. AZASS owns the hospital and all the services mentioned previously that have one executive leadership. Each municipality has proportioned vote according to number of citizens, but none can have a majority (so they need to look for common agreement). Executive board (5 mayors) manages and set rules for the director of the services. Supervisory board is formed by professionals (doctor, economist) and 3 mayors. Ad hoc commissions are formed to prepare strategic projects, so that experts and public can participate to create solutions for local problems. The director is negotiator in all those activities, suggest and recommends to mayors, but has to respect their final decision.

Key aspects that can be transferable:

  • Structured rules of cooperation on the development of AZASS shared by municipalities
  • Intense personal cooperation and communication with stakeholders and municipalities
  • Whole person approach to planning and provision of care/services including caregivers (carers) and their environment


Challenge addressed by the good practice

  1. Inaccessibility of health and social care/services/support delivered in continuum and holistic manner in the region (fragmented care, no support for carers and families)
  2. Small municipalities unable to solve the overall situation by their own means as their professional and financial capacity is too low.
  3. Transformation of acute hospital (that went bankrupt) to post-acute and long-term care facility (hospital) with cooperating primary care and some specialist physicians complementing the post-acute/long- term care unit.
  4. No systematic support for patients to transfer from hospital back home or to their community.
  5. Low quality of life of people with long-term care needs, reduced self-sufficiency due to disability/illness and their families due to lack of support/services enabling to stay at home or in the community as long as possible.

Key innovative elements of the good practice

  1. We cover the majority need of social and long-tem care/rehabilitation services by the local population.
  2. Accessible network of post-acute, health, long-term care and social services that are interlinked and interdisciplinary reacting to the needs of people and local community (creation of entirely new services).
  3. Intense and structured, legally based cooperation of municipalities on the development and sustainability of services provided – Municipalities are forced to communicate and cooperate on the development (increases the amount of cooperation and solidarity among municipalities, more civilised discussion among municipalities that are not otherwise motivated to cooperate/provide services for their inhabitants).
  4. Increase in quality of provided services, increased quality of life of those with long-term care needs and their carers.
  5. Stable and 2nd largest employer in the Polička region.

Full Scirocco information on the good practice

SciroccoGP-Olumouc-1-Integrated-health-and-social-care-services-AZASS.pdf [PDF]

Publications and reports on the good practice


Contact point: Mgr. Ing. Libor Stráník – director;

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