Abstract:
BACKGROUND:The use of case studies in health services research has proven to be an excellent methodology for gaining in-depth understanding of the organisation and delivery of health care. This is particularly relevant when looking at the complexity of integrated healthcare programmes, where multifaceted interactions occur at the different levels of care and often without a clear link between the interventions (new and/or existing) and their impact on outcomes (in terms of patients health, both patient and professional satisfaction and cost-effectiveness). Still, integrated care is seen as a core strategy in the sustainability of health and care provision in most societies in Europe and beyond. More specifically, at present, there is neither clear evidence on transferable factors of integrated care success nor a method for determining how to establish these specific success factors. The drawback of case methodology in this case, however, is that the in-depth results or lessons generated are usually highly context-specific and thus brings the challenge of transferability of findings to other settings, as different health care systems and different indications are often not comparable. Project INTEGRATE, a European Commission-funded project, has been designed to overcome these problems; it looks into four chronic conditions in different European settings, under a common methodology framework (taking a mixed-methods approach) to try to overcome the issue of context specificity and limited transferability. The common methodological framework described in this paper seeks to bring together the different case study findings in a way that key lessons may be derived and transferred between countries, contexts and patient-groups, where integrated care is delivered in order to provide insight into generalisability and build on existing evidence in this field. METHODOLOGY:To compare the different integrated care experiences, a mixed-methods approach has been adopted with the creation of a common methodological framework (including data collection tools and case study template report) to be used by the case studies for their analyses. METHODS OF ANALYSIS:The four case studies attempt to compare health care services before and after the 'integration' of care, while triangulating the findings using quantitative and qualitative data, and provide an in-depth description of the organisation and delivery of care, and the impact on outcomes. The common framework aims to allow for the extraction of key transferable learning from the cases, taking into account context-dependency. CONCLUSION:The application and evaluation of the common methodological approach aim to distill and identify important elements for successful integrated care, in order to strengthen the evidence base for integrated care (by facilitating cross-context comparisons), increase the transferability of findings from highly context-specific to other settings and lead to concrete and practical policy and operational recommendations.
journal_name
Int J Integr Carejournal_title
International journal of integrated careauthors
Cash-Gibson L,Rosenmoller Mdoi
10.5334/ijic.1980subject
Has Abstractpub_date
2014-12-15 00:00:00pages
e035issn
1568-4156journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Improving the healthcare for patients with depression is a priority health policy across the world. Roughly, two major problems can be identified in daily practice: (1) the content of care is often not completely consistent with recommendations in guidelines and (2) the organization of care is not always int...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.314
更新日期:2009-06-15 00:00:00
abstract:INTRODUCTION:Increasing continuity of care has been identified as a strategy to improve patient outcomes, but previous studies of integrated care have tended to focus on pilot areas, which limit their generalisability and the ability to determine in which contexts integrated care was most successful. OBJECTIVE:This st...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.2450
更新日期:2016-03-31 00:00:00
abstract:Background:Chronicity, and particularly complex care needs for people with chronic diseases is one of the main challenges of health systems. Objective:To determine the population prevalence of people with chronic diseases and complex care needs and to characterize these needs considering features of health and social ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.3292
更新日期:2018-05-25 00:00:00
abstract::HealthOne was part of a state-wide initiative to invest in new community-based facilities for collocating services. The HealthOne Mount Druitt is a virtual hub and spoke organisation established in 2006 in a socially disadvantaged part of Western Sydney based out of a new community health hub. The model is based on 'v...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.2243
更新日期:2015-09-23 00:00:00
abstract:INTRODUCTION:Miscommunication and lack of coordination can compromise care quality and patient safety during transitions in care, especially for medically complex older adults. Little research has been done to investigate care transitions from the perspective of those receiving and providing care. METHODS:This study e...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.1103
更新日期:2013-06-26 00:00:00
abstract:Introduction:To meet the needs of vulnerable people, the integration of services across different sectors is important. This paper presents a preliminary review of service integration across sectors in Europe. Examples of service integration between social services, health, employment and/or education were studied. A f...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.3107
更新日期:2018-04-19 00:00:00
abstract:INTRODUCTION:Multidisciplinary group meetings are one of the key drivers of facilitating integrated care. Health care professionals attending such groups have a key role in the success of these discussions and hence, in the forming of multi-professional integrated care. The study aimed to explore the professionals' exp...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.2019
更新日期:2015-09-02 00:00:00
abstract:OBJECTIVES:The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital) is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.649
更新日期:2011-07-01 00:00:00
abstract:INTRODUCTION:The 2004 Children Act in the UK saw the introduction of integrated working in children's services. A raft of change followed with processes designed to make joint working easier, and models and theories to support the development of integrated work. This paper explores the links between key concepts and pr...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.750
更新日期:2012-01-01 00:00:00
abstract::This article explores legislative provisions in relation to patient privacy in the context of integrated health and social care and the development of multidisciplinary health care teams that include practitioners from private sector and government agencies in the health, education, child protection, family welfare, d...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.5591
更新日期:2020-11-19 00:00:00
abstract:Introduction:Integrated care systems as well as accountable care organisations (ACOs) in the US and similar concepts in other countries are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursem...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.3615
更新日期:2018-01-12 00:00:00
abstract::This paper aims to identify problems in estimating and the interpretation of the magnitude of intervention-related change over time or responsiveness assessed with health outcome measures. Responsiveness is a problematic construct and there is no consensus on how to quantify the appropriate index to estimate change ov...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.65
更新日期:2002-01-01 00:00:00
abstract:PURPOSE:This paper reports on some of the findings of a literature review commissioned to explore integrated care for older people. METHODS:The process of revising included finding and selecting literature from multidisciplinary sources, and encompassed both published papers and 'grey' literature, i.e. material which ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.119
更新日期:2005-01-01 00:00:00
abstract:INTRODUCTION:The aim of this study is to explore the obstacles to collaborations between nurses in hospital and municipal care in the discharge of hospital patients who need continuing care. METHODS:First, we conducted in-depth interviews of nurses in hospitals and nurses in municipal care. Second, we developed questi...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.858
更新日期:2013-03-14 00:00:00
abstract:Introduction:Current U.S. policy and payment initiatives aim to encourage health care provider accountability for population health and higher value care, resulting in efforts to integrate providers along the continuum. Providers work together through diverse organizational structures, yet evidence is limited regarding...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4635
更新日期:2020-01-20 00:00:00
abstract:BACKGROUND:Disease management programs (DMP) aim at improving coordination and quality of care and reducing healthcare costs for specific chronic diseases. This paper investigates to what extent total healthcare utilization of type 2 diabetes patients is actually related to diabetes and its implications for diabetes ma...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.675
更新日期:2011-10-01 00:00:00
abstract:Background:Most current care models are disease- or symptom-focused and mostly do not account for the individual needs of patients with chronic diseases. The aim of this study was to develop an innovative, evidence-based and expert-based practice model for the management of patients with type 2 diabetes mellitus. Meth...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4646
更新日期:2020-04-22 00:00:00
abstract:Introduction:Primary care is increasingly being confronted with complex health care demands stemming from both biomedical and psychosocial problems of people with chronic diseases. Interprofessional collaboration is needed to enhance person-centredness and coordinate care provision in an efficient manner, which should ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4179
更新日期:2018-12-13 00:00:00
abstract:Introduction:China has adopted a people-centred integrated care model to reform its severely hospital-centric and fragmented delivery system. As a template of this model in urban China, the Luohu Hospital Group has generated considerable public and academic interest to scale it up. Methods:Guided by a policy triangle ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4673
更新日期:2020-03-16 00:00:00
abstract:BACKGROUND:Integration involves the coordination of services provided by autonomous agencies and improves the organization and delivery of multiple services for target patients. Current measures generally do not distinguish between agencies' perception and expectation. We propose a method for quantifying the agencies' ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.835
更新日期:2012-09-18 00:00:00
abstract:PURPOSE:Description and analysis of the effects and side-effects of integrated mental health care in the Netherlands. CONTEXT OF CASE:Due to a number of large-scale mergers, Dutch mental health care has become an illustration of integration and coherence of care services. This process of integration, however, has not ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.198
更新日期:2007-08-27 00:00:00
abstract:PURPOSE:To investigate the circumstances as to why it is so difficult in the primary care sector to implement IT based infrastructures supporting shared care. CASE STUDY:The qualitative analysis includes two separate case studies of IT-supported shared care implemented in two different regions of Denmark throughout 20...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.187
更新日期:2007-05-30 00:00:00
abstract:OBJECTIVE:We analysed the integrated planning model adopted by the Italian region Emilia Romagna in year 2000 to cover the entire range of treatment of cardiovascular disease. This model, called "hub and spoke", provides for the transfer of patient care and treatment from peripheral units (the spokes) to central units ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.82
更新日期:2003-01-01 00:00:00
abstract::The International Foundation for Integrated Care (IFIC) recently celebrated its 20th International Conference (ICIC20) through a virtual event that brought together patients and carers, academics, care professionals, NGOs, policy-makers and industry partners from across the global integrated care community [1]. The In...
journal_title:International journal of integrated care
pub_type: 社论
doi:10.5334/ijic.5627
更新日期:2020-10-21 00:00:00
abstract:PROBLEM STATEMENT:Health care delivery in Germany is highly fragmented, resulting in poor vertical and horizontal integration and a system that is focused on curing acute illness or single diseases instead of managing patients with more complex or chronic conditions, or managing the health of determined populations. Wh...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.311
更新日期:2009-04-20 00:00:00
abstract:INTRODUCTION:The objective of this study was to assess a model for improving healthcare integration for patients with multiple chronic diseases in an integrated healthcare organisation in the Basque Country and to propose areas for improvement. METHODS:We organised four nominal groups composed of representatives from ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.1975
更新日期:2016-08-19 00:00:00
abstract:THEME:Two central themes permeate this paper-the interplay between structure and agency in integration processes and the extent to which this is mediated through sensemaking by individual actors. CASE STUDY:The empirical base for the paper is provided by case study research from Wales which draws on examples of differ...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.509
更新日期:2009-12-22 00:00:00
abstract:Introduction:Not surprisingly given their multi-component nature, initiatives to improve integrated care often evolve to find the best way to bring about change. This paper provides an example of how an evaluation evolved alongside such an initiative designed to better integrate care across primary, community and hospi...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4183
更新日期:2019-04-05 00:00:00
abstract:Introduction:The aim of this review is to systematically assess the methodological quality of economic evaluations in integrated care and to identify challenges with conducting such studies. Theory and methods:Searches of grey-literature and scientific papers were performed, from January 2000 to December 2018. A check...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.4675
更新日期:2019-09-09 00:00:00
abstract:INTRODUCTION:A growing number of people are living with complex care needs characterized by multimorbidity, mental health challenges and social deprivation. Required is the integration of health and social care, beyond traditional health care services to address social determinants. This study investigates key care com...
journal_title:International journal of integrated care
pub_type: 杂志文章
doi:10.5334/ijic.2944
更新日期:2017-07-21 00:00:00