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BMC Health Services Research
Published in: BMC Health Services Research 1/2020

01-12-2020 | Care | Research article

Measures for the integration of health and social care services for long-term health conditions: a systematic review of reviews

Authors: Laura Kelly, Jenny Harlock, Michele Peters, Ray Fitzpatrick, Helen Crocker

Published in: BMC Health Services Research | Issue 1/2020

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Abstract

Background

As people are living longer with higher incidences of long-term health conditions, there is a move towards greater integration of care, including integration of health and social care services. Integrated care needs to be comprehensively and systematically evaluated if it is to be implemented widely. We performed a systematic review of reviews to identify measures which have been used to assess integrated care across health and social care services for people living with long-term health conditions.

Methods

Four electronic databases (PUBMED; MEDLINE; EMBASE; Cochrane library of systematic reviews) were searched in August 2018 for relevant reviews evaluating the integration of health and social care between 1998 and 2018. Articles were assessed according to apriori eligibility criteria. A data extraction form was utilised to collate the identified measures into five categories.

Results

Of the 18 articles included, system outcomes and process measures were most frequently identified (15 articles each). Patient or carer reported outcomes were identified in 13 articles while health outcomes were reported in 12 articles. Structural measures were reported in nine articles. Challenges to measuring integration included the identification of a wide range of potential impacts of integration, difficulties in comparing findings due to differences in study design and heterogeneity of types of outcomes, and a need for appropriate, robust measurement tools.

Conclusions

Our review revealed no shortage of measures for assessing the structures, processes and outcomes of integrated care. The very large number of available measures and infrequent use of any common set make comparisons between schemes more difficult. The promotion of core measurement sets and stakeholder consultation would advance measurement in this area.
Appendix
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Literature
1.
Garin N, Koyanagi A, Chatterji S, Tyrovolas S, Olaya B, Leonardi M, Lara E, Koskinen S, Tobiasz-Adamczyk B, Ayuso-Mateos JL, Haro JM. Global multimorbidity patterns: a cross-sectional, population-based, multi-country study. J Gerontol A Biol Sci Med Sci. 2016;71(2):205–14.CrossRef
2.
3.
Hopman P, de Bruin SR, Forjaz MJ, Rodriguez-Blazquez C, Tonnara G, Lemmens LC, Onder G, Baan CA, Rijken M. Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: a systematic literature review. Health Policy. 2016;120(7):818–32.CrossRef
4.
de Bruin SR, Versnel N, Lemmens LC, Molema CCM, Schellevis FG, Nijpels G, Baan CA. Comprehensive care programs for patients with multiple chronic conditions: a systematic literature review. Health Policy. 2012;107(2–3):108–45.CrossRef
5.
Allen D, Gillen E, Rixson L. The effectiveness of integrated care pathways for adults and children in health care settings: a systematic review. JBI Libr Syst Rev. 2009;7(3):80–129.CrossRef
6.
7.
Mujica-Mota RE, Roberts M, Abel G, Elliott M, Lyratzopoulos G, Roland M, Campbell J. Common patterns of morbidity and multi-morbidity and their impact on health-related quality of life: evidence from a national survey. Qual Life Res. 2015;24(4):909–18.CrossRef
8.
9.
10.
11.
12.
13.
Baxter S, Johnson M, Chambers D, Sutton A, Goyder E, Booth A. The effects of integrated care: a systematic review of UK and international evidence. BMC Health Serv Res. 2018;18(1):350.CrossRef
14.
Forder J, Caiels J, Harlock J, Wistow G, Malisauskaite G, Peters M, Marczak J, D’Amico F, Fernandez JL, Fitzpatric R, Jones K. A system-level evaluation of the better care fund: final report. Quality and Outcomes of Person-Centred Care Policy Research Unit. 2018. https://​www.​pssru.​ac.​uk/​pub/​5424.​pdf. Accessed 8 Feb 2019.
15.
Suter E, Oelke ND, da Silva Lima MAD, Stiphout M, Janke R, Witt RR, Van Vliet-Brown C, Schill K, Rostami M, Hepp S, Birney A, Al-Roubaiai F, Marques GQ. Indicators and measurement tools for health systems integration: a knowledge synthesis. Int J Integr Care. 2017;17(6):4.CrossRef
16.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.CrossRef
17.
18.
Donabedian A. Evaluating the quality of medical care. 1966. Milbank Q. 2005;83(4):691–729.CrossRef
19.
20.
Bautista MAC, Nurjono M, Lim YW, Dessers E, Vrijhoef HJ. Instruments measuring integrated care: a systematic review of measurement properties. Milbank Q. 2016;94(4):862–917.CrossRef
21.
Busse R, Stahl J. Integrated care experiences and outcomes in Germany, the Netherlands, and England. Health Aff. 2014;33(9):1549–58.CrossRef
22.
Cameron A, Lart R, Bostock L, Coomber C. Factors that promote and hinder joint and integrated working between health and social care services: a review of research literature. Health Soc Care Community. 2014;22(3):225–33.CrossRef
23.
Laver K, Lannin NA, Bragge P, Hunter P, Holland AE, Tavender E, O'Connor D, Khan F, Teasell R, Gruen R. Organising health care services for people with an acquired brain injury: an overview of systematic reviews and randomised controlled trials. BMC Health Serv Res. 2014;14:397.CrossRef
24.
Rutten-van Molken M, Leijten F, Hoedemakers M, Tsiachristas A, Verbeek N, Karimi M, Bal R, de Bont A, Islam K, Askildsen JE, Czypionka T, Kraus M, Huic M, Pitter JG, Vogt V, Stokes J, Baltaxe E, SELFIE consortium. Strengthening the evidence-base of integrated care for people with multi-morbidity in Europe using Multi-Criteria Decision Analysis (MCDA). BMC Health Serv Res. 2018;18:576.CrossRef
25.
Backhouse A, Ukoumunne OC, Richards DA, McCabe R, Watkins R, Dickens C. The effectiveness of community-based coordinating interventions in dementia care: a meta-analysis and subgroup analysis of intervention components. BMC Health Serv Res. 2017;17(1):717.CrossRef
26.
Soto TA, Bell J, Pillen MB. Literature on integrated HIV care: a review. AIDS Care. 2004;16(Suppl 1):S43–55.CrossRef
27.
Tummers JF, Schrijvers AJ, Visser-Meily JM. Economic evidence on integrated care for stroke patients; a systematic review. Int J Integr Care. 2012;12:e193.CrossRef
28.
Davies SL, Goodman C, Bunn F, Victor C, Dickinson A, Iliffe S, Gage H, Martin W, Froggatt. A systematic review of integrated working between care homes and health care services. BMC Heal Serv Res. 2011;11:320.CrossRef
29.
Eklund K, Wilhelmson K. Outcomes of coordinated and integrated interventions targeting frail elderly people: a systematic review of randomised controlled trials. Health Soc Care Community. 2009;17(5):447–58.CrossRef
30.
Kirst M, Im J, Burns T, Baker GR, Goldhar J, O’Campo P, Wojtak A, Wodchis WP. What works in implementation of integrated care programs for older adults with complex needs? A realist review. Int J Qual Heal Care. 2017;29(5):612–24.CrossRef
31.
Mason A, Goddard M, Weatherly H, Chalkley M. Integrating funds for health and social care: an evidence review. J Health Serv Res Policy. 2015;20(3):177–88.CrossRef
32.
Stewart MJ, Georgiou A, Westbrook JI. Successfully integrating aged care services: a review of the evidence and tools emerging from a long-term care program. Int J Integr Care. 2013;13:e003.CrossRef
33.
Strandberg-Larsen M, Krasnik A. Measurement of integrated healthcare delivery: a systematic review of methods and future research directions. Int J Integr Care. 2009;9:e01.CrossRef
34.
Valaitis RK, Carter N, Lam A, Nicholl J, Feather J, Cleghorn L. Implementation and maintenance of patient navigation programs linking primary care with community-based health and social services: a scoping literature review. BMC Health Serv Res. 2017;17(1):116.CrossRef
35.
36.
37.
Reay N. How to measure patient experience and outcomes to demonstrate quality in care. Nurs Times. 2010;106(7):12–4.PubMed
38.
Kingsley C, Patel S. Patient-reported outcome measures and patient-reported experience measures. BJA Educ. 2017;17(4):137–44.CrossRef
39.
40.
Moloney RM, Messner DA, Tunis SR. The increasing complexity of the core outcomes landscape. J Clin Epidemiol. 2019;116:150–4.CrossRef
41.
42.
Williamson PR, Altman DG, Bagley H, Barnes KL, Blazeby JM, Brookes ST, Clarke M, Gargon E, Gorst S, Harman N, Kirkham JJ, McNair A, CAC P, Schmitt J, Terwee CB, Young B. The COMET Handbook: version 1.0. Trials. 2017;18(S3):280.CrossRef
43.
44.
Baxter SK, Blank L, Woods HB, Payne N, Rimmer M, Goyder E. Using logic model methods in systematic review synthesis: describing complex pathways in referral management interventions. BMC Med Res Methodol. 2014;14(1):62.CrossRef
45.
Metadata
Title
Measures for the integration of health and social care services for long-term health conditions: a systematic review of reviews
Authors
Laura Kelly
Jenny Harlock
Michele Peters
Ray Fitzpatrick
Helen Crocker
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Health Services Research / Issue 1/2020
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-020-05206-5

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