Introduction of novel complex integrated care models supported by digital health interventions in European primary settings: a scoping review

IF 3.4 3区 医学 Q1 HEALTH POLICY & SERVICES
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引用次数: 0

Abstract

Introduction

There remains the need to develop comprehensive organisational care models supported by digital health interventions (DHIs) to manage chronic conditions in primary healthcare.

Objective

this review aimed to identify and map methods, interventions and outcomes investigated regarding the introduction of novel complex integrated care models supported by DHIs in the European primary care setting, as well as the level of integration achieved.

Methods

a scoping review to identify literature from 2013 to 2023 in the European context was conducted across PubMed, Scopus and Web of Science. DHIs description, care models and outcomes were reported using the PRISMA- ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.

Results

A total of 53 studies was included. The models introduced, along with a DHI, at least one innovation in their structure or in the modality of care delivery: either a new figure (44%), interprofessional collaboration (37%), new functions like person-centred care (59%) or population stratification (11%). As regarding the DHIs, 56% implemented monitoring/management platforms and apps for chronic conditions. The most frequent combination of care model-DHI was the introduction of an app/platform, supported by phone calls/texts and electronic health records, paired with the introduction of a new healthcare professional/person centred care/ multidisciplinary team. All the studies reaching statistically significant outcomes introduced, along with one or more DHIs, either a new figure or a multidisciplinary team as part of the organizational change to support the technology.

Conclusions

novel complex integrated care models are focusing on introducing multidisciplinary perspectives and personalization of care, in line with the complex needs of chronic patients. The predominant development of monitoring/management platforms for patients is a further confirmation of this trend. Future research efforts should focus on the investigation of the effectiveness of current complex integrated care models integrating DHIs.

在欧洲基层医疗机构引入由数字医疗干预措施支持的新型复杂综合护理模式:范围界定综述
引言目前仍然需要开发由数字健康干预措施(DHI)支持的综合组织护理模式,以管理初级医疗保健中的慢性疾病。方法在 PubMed、Scopus 和 Web of Science 上进行了范围界定审查,以确定 2013 年至 2023 年欧洲范围内的文献。采用 PRISMA- ScR(系统综述和荟萃分析的首选报告项目扩展至范围界定综述)指南对 DHIs 描述、护理模式和结果进行了报告。这些模式在其结构或提供护理的方式中至少引入了一项创新:新数字(44%)、专业间合作(37%)、以人为本的护理等新功能(59%)或人口分层(11%)。至于 DHIs,56% 的 DHIs 实施了慢性病监测/管理平台和应用程序。最常见的护理模式-DHI组合是在电话/短信和电子健康记录的支持下引入应用程序/平台,同时引入新的医疗保健专业人员/以人为本的护理/多学科团队。所有研究都取得了具有统计学意义的成果,在引入一个或多个 DHI 的同时,还引入了一个新的人物或一个多学科团队,作为支持技术的组织变革的一部分。为患者开发监控/管理平台是对这一趋势的进一步证实。未来的研究工作应侧重于调查目前整合了 DHIs 的复杂综合护理模式的有效性。
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来源期刊
Health Policy and Technology
Health Policy and Technology Medicine-Health Policy
CiteScore
9.20
自引率
3.30%
发文量
78
审稿时长
88 days
期刊介绍: Health Policy and Technology (HPT), is the official journal of the Fellowship of Postgraduate Medicine (FPM), a cross-disciplinary journal, which focuses on past, present and future health policy and the role of technology in clinical and non-clinical national and international health environments. HPT provides a further excellent way for the FPM to continue to make important national and international contributions to development of policy and practice within medicine and related disciplines. The aim of HPT is to publish relevant, timely and accessible articles and commentaries to support policy-makers, health professionals, health technology providers, patient groups and academia interested in health policy and technology. Topics covered by HPT will include: - Health technology, including drug discovery, diagnostics, medicines, devices, therapeutic delivery and eHealth systems - Cross-national comparisons on health policy using evidence-based approaches - National studies on health policy to determine the outcomes of technology-driven initiatives - Cross-border eHealth including health tourism - The digital divide in mobility, access and affordability of healthcare - Health technology assessment (HTA) methods and tools for evaluating the effectiveness of clinical and non-clinical health technologies - Health and eHealth indicators and benchmarks (measure/metrics) for understanding the adoption and diffusion of health technologies - Health and eHealth models and frameworks to support policy-makers and other stakeholders in decision-making - Stakeholder engagement with health technologies (clinical and patient/citizen buy-in) - Regulation and health economics
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