International Journal of Integrated Care最新文献

{"title":"Scale-Up of Integrated Care Interventions for Chronic Diseases in Diverse Settings.","authors":"Grace Marie Ku, Zalika Klemenc-Ketiš, Antonija Poplas-Susič, Roy Remmen, Wim Van Damme, Edwin Wouters, Josefien Van Olmen, Kerstin Klipstein-Grobusch","doi":"10.5334/ijic.8981","DOIUrl":"https://doi.org/10.5334/ijic.8981","url":null,"abstract":"","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 3","pages":"19"},"PeriodicalIF":2.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11396081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Strengths and Weaknesses for Implementing a Place-Based Model of Care for Older People on the Central Coast, Australia: Results of a Pilot Project Using the Population Health Management Maturity Index (PHM-MI) Tool.","authors":"Anna Francisca Teresia Maria van Ede, Nicholas Goodwin, Marc Abraham Bruijnzeels, Katharina Viktoria Stein","doi":"10.5334/ijic.8575","DOIUrl":"10.5334/ijic.8575","url":null,"abstract":"<p><strong>Introduction: </strong>Population health management is increasingly being used to support place-based models of care. This case study provides an account of the use of the Population Health Management - Maturity Index (PHM-MI) tool to inform the future development of a neighbourhood model of care for older people in the Central Coast region of Australia.</p><p><strong>Description: </strong>The PHM-MI tool comprises a set of six evidence-informed elements known to be important in enabling PHM in practice. As part of a joint strategic needs assessment, 17 selected stakeholders from key regional organizations were invited to undertake the PHM-MI tool survey. Three follow-up workshops were held to interpret the results and determine priority actions.</p><p><strong>Discussion: </strong>The PHM-MI scores revealed that the overall maturity of the Central Coast to successfully deliver PHM was low across all six elements, findings that were corroborated through participant workshops. Systemic fragmentations, most pertinently of funding and regulation, incentivised silo-based working. The need to formalise and strengthen regional collaborations, enable data integration, find creative ways to use existing funding streams, and promote community engagement were highlighted as core priorities.</p><p><strong>Conclusion: </strong>Using the PHM-MI tool was enabled by it being embedded within a pre-existing regional strategic process. The results were used to inform future regional priorities. The PHM-MI tool has the potential for use across regional or national contexts.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 3","pages":"18"},"PeriodicalIF":2.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Integrated Care World is a Stage: Applying Goffman's Theory of Dramaturgy to the Activities of Integrated Care.","authors":"Carolyn Steele Gray, James Shaw, G Ross Baker, Kerry Kuluski, Walter P Wodchis","doi":"10.5334/ijic.8639","DOIUrl":"10.5334/ijic.8639","url":null,"abstract":"<p><p>Among the challenges in delivering integrated health and social care services is the need to attend to the coordination of tasks, roles, activities, and operations, while considering how these efforts are experienced by patients, carers and communities. The literature has noted an important disconnect between how providers and leaders view their efforts to coordinate service delivery, and how patients perceive these efforts on the receiving end. Our team has provided guidance to integrated care efforts in Ontario, Canada by drawing on Goffman's theory of Dramaturgy to help classify the actions of integrated care delivery as linked to the roles individuals play in the delivery of care. Using this framing helps to uncover how \"backstage\" processes (such as team-functioning, funding models, and digital infrastructures) create a necessary foundation on which \"frontstage\" actions (or performances) can be effectively delivered.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 3","pages":"17"},"PeriodicalIF":2.6,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Integrated Care for Diabetes Mellitus Type 2, Cardiovascular and Chronic Respiratory Diseases: A Systematic Review and Meta-Analysis.","authors":"Pim P Valentijn, Liza Tymchenko, Wiro Gruisen, Bem Bruls, Fernando Abdalla Pereira, Rosa Y Arends","doi":"10.5334/ijic.7744","DOIUrl":"10.5334/ijic.7744","url":null,"abstract":"<p><strong>Introduction: </strong>In this paper, we use the Rainbow Model of Integrated Care (RMIC) framework to evaluate the effectiveness of integrated care in terms of enhancing the outcomes of chronic conditions such as diabetes mellitus type 2 (DMT2), cardiovascular diseases (CVD), chronic respiratory diseases (CRD), or their combinations.</p><p><strong>Methods: </strong>The data extracted from randomized controlled trials (RCT) of integrated care interventions for DMT2, CVD, and CRD (follow-up ≥ 3 months) in 11 databases were analysed using random-effects meta-analysis.</p><p><strong>Results: </strong>A total of 54 eligible studies covering 12,976 participants, with a mean follow-up of 54 weeks, were included. In moderate-quality evidence, integrated care interventions reduced mortality for CVD, adverse events for CVD and DMT2, and improved quality of life for CVD and DMT2, physical and mental functioning, self-management, and blood pressure control.</p><p><strong>Conclusion: </strong>Integrated care can reduce all-cause mortality, adverse events, and improve quality of life, physical and mental functioning, self-management and blood pressure control in chronic disease patients. However, available evidence for some outcomes (e.g., all-cause hospital admissions) remains uncertain.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 3","pages":"16"},"PeriodicalIF":2.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling-Out Digitally Enabled Integrated Care in Europe Through Good Practices Transfer: The JADECARE Study.","authors":"Ane Fullaondo, Yhasmine Hamu, Jon Txarramendieta, Esteban de Manuel","doi":"10.5334/ijic.8605","DOIUrl":"10.5334/ijic.8605","url":null,"abstract":"<p><strong>Introduction: </strong>The absence of a coordinated approach to health and social care compromises the ability of health systems to provide universal, equitable, high-quality, and financially sustainable care. Transferring evidence-based practices focused on digitally-enabled integrated care to new contexts can overcome this challenge if implementation is satisfactory. This paper presents the scaling-out methodology that JADECARE has designed to spread effective innovative practices across Europe.</p><p><strong>Methodology: </strong>The scaling-out methodology pretends to guide the Next Adopters in the transfer and adoption of practices, whereas increasing their implementation capacity and providing an evaluation framework to assess impact and success.</p><p><strong>Discussion: </strong>JADECARE scaling-out effort is based on guiding principles found in the literature such as the balance between fidelity to the original practice and the degree of adaptation required to fit the new context, the need for capacity building in implementation to bridge the gap between research and routine practice and the focus on explaining why, for whom and in what circumstances an intervention works.</p><p><strong>Conclusion: </strong>The JADECARE scaling-out methodology is theory-driven and pragmatic and aims to facilitate the transfer of complex interventions across different contexts.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 3","pages":"15"},"PeriodicalIF":2.6,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11312721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inside the Black Box: Examining the Interconnectivity of Components of Integrated Person-Centred Care for Vulnerable Groups Through a Realist Lens.","authors":"Anam Ahmed","doi":"10.5334/ijic.8655","DOIUrl":"10.5334/ijic.8655","url":null,"abstract":"<p><p>Integrated person-centred care (IPCC) for vulnerable groups is complex and multifaceted and cannot be reduced to simple cause-and-effect relationships. The effectiveness varies across settings due to differing contexts and mechanisms. By applying realist research, this dissertation examines the relationships between the context in which IPCC for vulnerable groups in the Netherlands is applied, the mechanisms by which IPCC (does not) work(s), and the outcomes resulting from this interaction. The findings provide deeper insights into interrelatedness of items that influence effectiveness of IPCC, emphasizing the significance of understanding their interplay and recognizing that they form a larger interconnected system rather than acting independently.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 3","pages":"14"},"PeriodicalIF":2.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11312831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and Barriers in Integrated Social Care for Families Facing Multiple and Complex Problems: A Scoping Review.","authors":"Marcel van Eck, Roelof Ettema, Mariëlle Cloin, Tine Van Regenmortel","doi":"10.5334/ijic.7768","DOIUrl":"10.5334/ijic.7768","url":null,"abstract":"<p><strong>Introduction: </strong>Families with multiple and complex problems often deal with multiple professionals and organizations for support. Integrated social care supposedly prevents the fragmentation of care that often occurs.We identified facilitators and barriers experienced by families receiving integrated social care and by the professionals who provide it.</p><p><strong>Method: </strong>We performed a scoping review following Arksey and O'Malley's framework, using the following databases: PsycINFO, Web of Science Core Collection, Psychology and Behavioral Sciences Collection, CINAHL, PubMed, and Medline. Furthermore, conducted a thematic analysis. The results were divided into facilitators and barriers of integrated social care.</p><p><strong>Results: </strong>We identified 278 studies and finally included sixteen in our scoping review. We identified facilitators, including: linking formal care with informal networks, promoting collaboration among professionals e.g., working in pairs, and professionals autonomy. We identified barriers, including: time constraints, tasks outside professionals' expertise, along with resistance to integrated collaboration among organizations. These findings can enhance the advancement of social integrated care as a promising approach to support families facing multiple and complex problems.</p><p><strong>Conclusion: </strong>To empower families, integrated social care requires a systematic approach based on trust. It involves coordinated care, shared decision-making, informal networks and the participation of all family members, including children.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 3","pages":"13"},"PeriodicalIF":2.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11312847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The BigMove Intervention for People With Physical and Mental Health Conditions: A First Evaluation of Self-Perceived Health, Quality of Life, Coping and Mental and Social Functioning.","authors":"Sabina van der Veen, Natalie Evans, Guy Widdershoven, Martijn Huisman","doi":"10.5334/ijic.8317","DOIUrl":"10.5334/ijic.8317","url":null,"abstract":"<p><strong>Background: </strong>The BigMove intervention aims to improve the functioning and quality of life of people with physical and mental health conditions via an integrated care approach. This pilot study evaluates the impact of the intervention on self-perceived health (SPH), quality of life (QoL), active coping behaviour, and mental and social functioning.</p><p><strong>Methods: </strong>Data were analysed from N = 457 participants who had been referred to the intervention by their general practitioner (mean age 48.98 years; 76% female). Three patient-reported and one clinician-rated measures were used: SPH, QoL (MANSA), active coping behaviour (UPCC-ACT), mental and social functioning (HoNOS). Pre- and post-intervention measurements (from 2011 to 2018) were compared using paired-samples t-tests. Due to missing data, analyses were conducted with 205-257 participants per completed outcome. Associations with age and sex were assessed using repeated-measures ANOVA. Clinically relevant change was evaluated with the Edwards-Nunnally index and standard error of measurement (SEM) scores.</p><p><strong>Results: </strong>Post-intervention, there were statistically significant improvements for all outcomes (p < 0.0001) with moderate to large effect sizes (<i>d</i> = 0.41 to 1.02). The observed changes in outcomes can be considered as clinically relevant improvements.</p><p><strong>Conclusion: </strong>This pilot study provides preliminary evidence that the intervention has positive effects on SPH, QoL, active coping behaviour, and mental and social functioning.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"12"},"PeriodicalIF":2.6,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11312720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aligning Ambition and Reality: A Multiple Case Study Into Synergistic Influences of Financial and Other Factors on the Outcomes of Integrated Care Projects.","authors":"Sanne Allers, Frank Eijkenaar, Frederik T Schut, Erik M van Raaij","doi":"10.5334/ijic.7736","DOIUrl":"10.5334/ijic.7736","url":null,"abstract":"<p><strong>Introduction: </strong>While the benefits of integrated care are widely acknowledged, its implementation has proven difficult. Together with other factors, financial factors are known to influence progress towards care integration, but in-depth insight in their influence on the envisioned outcomes of integrated care projects is limited.</p><p><strong>Methods: </strong>We conducted a multiple case study of four integrated care projects in the Netherlands. The projects were purposely sampled to be representative of integrated care in its different forms. A total of 29 semi-structured interviews were held with project members, both medical and non-medical staff. In addition, 141 documents were analyzed, including scientific publications and minutes of meetings. Based on elaborate project descriptions we deduced the synergistic influences of financial and other factors on the outcomes of the projects.</p><p><strong>Results: </strong>Financial factors have an important influence on integrated care projects, though this influence is neither deterministic nor isolated. This is because the likelihood of realizing a positive outcome is affected by the degree to which four key conditions are fulfilled: 1) willingness to change, 2) alignment of interests and uniformity goal, 3) availability of resources to change, and 4) effectiveness of management of external actors.</p><p><strong>Conclusion: </strong>Financial factors have an impact on the outcomes of integrated care projects and must be viewed in synergy with interrelated other factors. Crucial for realizing success in integrated care, a balance must be struck between the level of ambition set in a project and the reality of the prevailing key conditions.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 1","pages":"11"},"PeriodicalIF":2.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Danish Ibbis Trials for Sickness Absentees with Common Mental Disorders: A Phase 4 Prospective Study Comparing Randomized Trial and Real-World Data.","authors":"Andreas Hoff, Anders Bo Bojesen, Lene Falgaard Eplov","doi":"10.5334/ijic.7562","DOIUrl":"10.5334/ijic.7562","url":null,"abstract":"<p><strong>Introduction: </strong>In two randomized controlled trials (RCT) we tested the efficacy of a novel integrated vocational rehabilitation and mental healthcare intervention, coined INT, for sickness absentees with common mental disorders. The aim was to improve vocational outcomes compared to Service As Usual (SAU). Contrary to expectations, the delivered intervention caused worse outcomes within some diagnostic groups and some benefits in others. In this phase 4 study, we examined the effectiveness of the intervention in real-world practice.</p><p><strong>Method: </strong>In this prospective intervention study, we allocated adult sickness absentees with either depression, anxiety, or adjustment disorder to receive INT in a real-world setting in a Danish Municipality. We compared the vocational outcomes of this group to a matched group who received INT as a part of the RCTs, after randomization to the intervention group herein. Primary outcome was return to work at any point within 12 months.</p><p><strong>Results: </strong>In the real-world group, 151 participants received INT during 2019. From the randomized trials, 302 matched participants who received INT between 2016-2018 were included. On the primary outcome - return to work within 12 months - the real-word group fared worse (48.3 vs 64.6 %, OR 0.54 [95%CI: 0.37-0.79], p = 0.001). Across most other vocational outcomes, a similar pattern of statistically significant poorer outcomes in the real-world group was observed: Lower number of weeks in work and lower proportion in work at 12 months (42.3% vs. 58.3% (p = 0.002)).</p><p><strong>Discussion: </strong>The real-word group showed significantly worse vocational outcomes. Like in many other studies of complex interventions, implementation was difficult in the original randomized trials and perhaps even more difficult in the less structured real-world setting. Since the intervention was less effective for some groups compared to SAU in the original trial, this negative effect may be even more pronounced in a real-world setting.</p>","PeriodicalId":14049,"journal":{"name":"International Journal of Integrated Care","volume":"24 3","pages":"10"},"PeriodicalIF":2.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11276403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}