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BMC Primary Care
Published in: BMC Primary Care 1/2015

Open Access 01-12-2015 | Research article

Towards an international taxonomy of integrated primary care: a Delphi consensus approach

Authors: Pim P. Valentijn, Hubertus J. M. Vrijhoef, Dirk Ruwaard, Inge Boesveld, Rosa Y. Arends, Marc A. Bruijnzeels

Published in: BMC Primary Care | Issue 1/2015

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Abstract

Background

Developing integrated service models in a primary care setting is considered an essential strategy for establishing a sustainable and affordable health care system. The Rainbow Model of Integrated Care (RMIC) describes the theoretical foundations of integrated primary care. The aim of this study is to refine the RMIC by developing a consensus-based taxonomy of key features.

Methods

First, the appropriateness of previously identified key features was retested by conducting an international Delphi study that was built on the results of a previous national Delphi study. Second, categorisation of the features among the RMIC integrated care domains was assessed in a second international Delphi study. Finally, a taxonomy was constructed by the researchers based on the results of the three Delphi studies.

Results

The final taxonomy consists of 21 key features distributed over eight integration domains which are organised into three main categories: scope (person-focused vs. population-based), type (clinical, professional, organisational and system) and enablers (functional vs. normative) of an integrated primary care service model.

Conclusions

The taxonomy provides a crucial differentiation that clarifies and supports implementation, policy formulation and research regarding the organisation of integrated primary care. Further research is needed to develop instruments based on the taxonomy that can reveal the realm of integrated primary care in practice.
Literature
1.
Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Aff. 2008;27(3):759–69.CrossRef
2.
WHO. The world health report 2008: primary health care - now more than ever. Geneva: World Health Organization; 2008.
3.
Valentijn PP, Schepman SM, Opheij W, Bruijnzeels MA. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care. 2013;13:e010.CrossRefPubMedPubMedCentral
4.
Kodner DL. All together now: a conceptual exploration of integrated care. Healthc Q. 2009;13(Special Issue):6–15.CrossRefPubMed
5.
Goodwin N. Understanding integrated care: a complex process, a fundamental principle. Int J Integr. 2013;13.
6.
Valentijn PP, Boesveld IC, van der Klauw DM, Ruwaard D, Struijs JN, Molema JJ, et al. Towards a taxonomy for integrated care: a mixed-methods study. Int J Integr Care. 2015;15.
7.
Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS One. 2011;6(6), e20476.CrossRefPubMedPubMedCentral
8.
Fitch K, Bernstein SJ, Aguilar MD, Burnand B, LaCalle JR. The RAND/UCLA appropriateness method user’s manual. Santa Monica (CA): RAND Corporation; 2001.
9.
10.
11.
12.
Thomas P, Meads G, Moustafa A, Nazareth I, Stange KC, Donnelly Hess G. Combined horizontal and vertical integration of care: a goal of practice-based commissioning. Qual Prim Care. 2008;16(6):425–32.PubMed
13.
Ahgren B. The art of integrating care: theories revisited. Open Public Health J. 2012;5:36–9.CrossRef
14.
Axelsson R, Axelsson SB. Integration and collaboration in public health—a conceptual framework. Int J Health Plann Manage. 2006;21(1):75–88.CrossRefPubMed
15.
Shortell SM, Gillies RR, Anderson DA, Erickson KM, Mitchell JB. Remaking health care in America. San Francisco: Jossey-Bass; 1996.
16.
Armitage GD, Suter E, Oelke ND, Adair CE. Health systems integration: state of the evidence. Int J Integr Care. 9.
17.
Suter E, Oelke ND, Adair CE, Armitage GD. Ten key principles for successful health systems integration. Healthcare Q (Toronto, Ont). 2009;13(Spec No):16.CrossRef
18.
Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996:511–44.
19.
Vasan A, Ellner A, Lawn SD, Gove S, Anatole M, Gupta N, et al. Integrated care as a means to improve primary care delivery for adults and adolescents in the developing world: a critical analysis of Integrated Management of Adolescent and Adult Illness (IMAI). BMC Med. 2014;12(1):6.CrossRefPubMedPubMedCentral
20.
21.
Pastor M, Morello-Frosch R. Integrating public health and community development to tackle neighborhood distress and promote well-being. Health Aff (Millwood). 2014;33(11):1890–6.CrossRef
22.
Bhatia R. Case study: San Francisco’s use of neighborhood indicators to encourage healthy urban development. Health Aff (Millwood). 2014;33(11):1914–22.CrossRef
23.
Herdman M, Rajmil L, Ravens‐Sieberer U, Bullinger M, Power M, Alonso J. Expert consensus in the development of a European health‐related quality of life measure for children and adolescents: a Delphi study. Acta Paediatr. 2002;91(12):1385–90.CrossRefPubMed
24.
Elwyn G, O’Connor A, Stacey D, Volk R, Edwards A, Coulter A, et al. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006;333(7565):417.CrossRefPubMedPubMedCentral
25.
Baltussen R, Mikkelsen E, Tromp N, Hurtig A, Byskov J, Olsen O, et al. Balancing efficiency, equity and feasibility of HIV treatment in South Africa - development of programmatic guidance. Cost Eff Resour Alloc. 2013;11(1):26. 7547-11-26.CrossRefPubMedPubMedCentral
26.
Venhorst K, Zelle SG, Tromp N, Lauer JA. Multi-criteria decision analysis of breast cancer control in low-and middle-income countries: development of a rating tool for policy makers. Cost Eff Resour Alloc. 2014;12(1):13.CrossRefPubMedPubMedCentral
27.
Chow CC, Luk P. A strategic service quality approach using analytic hierarchy process. Managing Serv Qual. 2005;15(3):278–89.CrossRef
Metadata
Title
Towards an international taxonomy of integrated primary care: a Delphi consensus approach
Authors
Pim P. Valentijn
Hubertus J. M. Vrijhoef
Dirk Ruwaard
Inge Boesveld
Rosa Y. Arends
Marc A. Bruijnzeels
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2015
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-015-0278-x

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