Ng SM, Mariguddi S, Coward S, Middleton H. Paediatric community home nursing: a model of acute care. Trivedi D, Goodman C, Gage H, Baron N, Scheibl F, Iliffe S, et al. 2012;20:20522. Quantitative primary studies and systematic reviews, reporting actual or perceived effects on service delivery following the introduction of models of integration or co-ordination, in healthcare or health and social care settings in developed countries were eligible for inclusion. Cochrane Database Syst Rev. Low L-F, Yap M, Brodaty H. A systematic review of different models of home and community care services for older persons. Rosenheck R, Leslie D, Sint K, Lin H, Robinson DG, Schooler NR, et al. Stewart M, Sangster JF, Ryan BL, Hoch JS, Cohen I, McWilliam CL, et al. Integrated care facilitation for older patients with complex health care needs reduces hospital demand. The disadvantages arising directly from the establishment of the CSME infrastructure which would influence the distribution of gains from market and economic integration, prior disadvantages. 2011;19:226. 2018;18:5. BMJ. In regard to similarities and differences between studies carried out in the UK and in other countries, we found three areas of variance in rating between UK evidence and the evidence overall. Models of integrated care encompass diverse initiatives that aim to improve integration of care across healthcare and between health and social care services. Fam Pract. As highly complex interventions, these models challenge linkage of particular elements of initiatives to effects, with a lack of clarity on which key elements are causally associated with positive outcomes. J Integrat Care Path. Eur J Obs Gynecol Reprod Biol. Sahlen KG, Boman K, Brannstrom M. A cost-effectiveness study of person-centered integrated heart failure and palliative home care: based on a randomized controlled trial. Curriculum development describes how a training or teaching organization plans and guides learning. PREFER: a randomized controlled study. 2015;23:7487. Roberts S, Unadkat N, Chandok R, Sawtell T. Learning from the integrated care pilot in West London. We identified an extensive range of outcomes from the literature. Am J Pub Health. Improved access may be perceived positively by patients, and enable serious conditions to be identified and treated earlier; but also may incur a detrimental effect on costs and capacity. J Interprof Care. Guerrero EG, Aarons GA, Palinkas LA. 2011;11:342. J Diabetes. Cookies policy. Ham C. Working Together for Health: Achievements and Challenges in the Kaiser NHS Beacon Sites Programme. Bakerly ND, Davies C, Dyer M, Dhillon P. Cost analysis of an integrated care model in the management of acute exacerbations of chronic obstructive pulmonary disease. We then compared this to the strength of evidence ratings assigned to the included studies as a whole. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. J Healthcare Qual. Lamb BW, Jalil RT, Sevdalis N, Vincent C, Green JS. This results in the improvement of competitive advantage for the company over their competitors. Imison C, Curry N, Holder H, Castle-Clarke S, Nimmons D, Appleby J, et al. Palliat Med. Cohen E, Lacombe-Duncan A, Spalding K, MacInnis J, Nicholas D, Narayanan U, et al. Five year forward view. The integrated implementation of two end-of-life care tools in nursing care homes in the UK: an in-depth evaluation. 2013;18:110. 2010;56:e209. 2006;26:917. the final year of the program, students take their first social studies education course along with a 96-hour practicum in the fall. Counsell S, Callahan C, Clark D, Tu W, Buttar A, Stump T, et al. Tucker H, Burgis M. Patients set the agenda on integrating community services in Norfolk. A literature review. Only two had utilised some form of random allocation to condition [44, 49], with allocation concealment not possible due to the nature of the intervention. The effects of integrated care: a systematic review of UK and international evidence. 2008;63:3217. Cancer. McGregor M, Lin E, Katon W. TEAMcare: an integrated multicondition collaborative care program for chronic illnesses and depression. It can bring about more difficulties. The implementation of highly complex whole-system change interventions such as new forms of integration is known to be challenging [188], and differing degrees of success in implementation may contribute to the varying outcomes reported. 2015;350:h2005. Homeschooling is generally short in providing peer-to-peer interactions to children. Blewett LA, Owen RA. A matched-pair cluster-randomized trial of guided care for high-risk older patients. Figure2 summarises the country of origin for the different types of study design. 1) Enhance the Competitive Advantage. Age Ageing. Google Scholar. J Adv Nurs. Mertes SC, Raut S, Khanduja V. Integrated care pathways in lower-limb arthroplasty: are they effective in reducing length of hospital stay? The effect of policy on end-of-life care practice within nursing care homes: a systematic review. Huws DW, Cashmore D, Newcombe RG, Roberts C, Vincent J, Elwyn G. Impact of case management by advanced practice nurses in primary care on unplanned hospital admissions: a controlled intervention study. By using this website, you agree to our Google Scholar. 2015;86:15368. J Am Geriatr Soc. Quality of integrated care for patients with nonsmall cell lung cancer: variations and determinants of care. Papers excluded and the reason for exclusion was recorded (available as Additional file 1: Appendix S4). Can Fam Physician. and the benefit of physical co-location of services [32]. Health Inf Libr J. 2010;363:124555. Practical applications of the interdisciplinary perspective Early effects of guided care on the quality of health care for multimorbid older persons: a cluster-randomized controlled trial. We examined the data regarding outcomes and impacts for studies in the two largest sub-groups of patients - older adults, and populations described as having complex needs. Google Scholar. BMC Health Serv Res. 2014;16:114251. BMC Health Serv Res. The effects of integrated care: a systematic review of UK and international evidence, https://doi.org/10.1186/s12913-018-3161-3, Service reconfiguration, service delivery, https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf, https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/implementing-the-nhs-five-year-forward-view-kingsfund-feb15.pdf, https://www.nao.org.uk/wp-content/uploads/2017/02/Health-and-social-care-integration.pdf, https://www.nuffieldtrust.org.uk/files/2017-02/shifting-the-balance-of-care-report-web-final.pdf, https://doi.org/10.1186/s12913-014-0590-5, https://doi.org/10.1002/14651858.CD010414.pub2, https://doi.org/10.1136/bmjopen-2012-000930, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215103/dh_133127.pdf, https://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/PolicyPapers/Policy-paper-6.pdf, https://doi.org/10.1136/bmjopen-2015-010468, https://doi.org/10.1016/j.jval.2014.08.259, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, bmchealthservicesresearch@biomedcentral.com. Factors enabling implementation of integrated health and social care: a systematic review. 2009;7:6174. While there appeared to be no clear pattern of differential outcomes between settings or initiatives, there appeared to be potential for more positive outcomes amongst those categorised by authors as having complex needs, although currently most research evidence comes from studies in older adults. Google Scholar. Simmons D, Yu D, Wenzel H. Changes in hospital admissions and inpatient tariff associated with a diabetes integrated care initiative: preliminary findings. GRADE guidelines: 8. CAS Article Lancet Respir Med. Wedel R, Kalischuk RG, Patterson E, Brown S. Turning vision into reality: successful integration of primary healthcare in Taber, Canada. Book 2011;34:15262. PubMed Central Palliat Med. Health Care Manag Rev. Authors did not make links between the context and outcomes of initiatives, apart from reported issues regarding staff training and retention in social care [38]. One of two international comparator studies (reported in three papers) supported the finding that quality of care was perceived by patients to have improved [123,124,125]. Alexander JA, Bae D. Does the patient-centred medical home work? Completed quality appraisals. Royal College of Nursing: Edinburgh; 2011. Emergency department transfers and hospital admissions from residential aged care facilities: a controlled pre-post design study. Appendix S4. Impact of Quebecs healthcare reforms on the organization of primary healthcare (PHC): a 2003-2010 follow-up. California Privacy Statement, Johnstone R, Jones A, Fowell A. Welsh collaborative care pathway project; 10 years experience of implementing and maintaining a care pathway for the last days of life. Just over half the included studies reported sample sizes that were sufficiently large to have confidence in the findings. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215103/dh_133127.pdf. J Health Serv Res Policy. Johnstone RP, Jones AR, Burton C, Fowell A. J Pediatr Infect Dis. Health Aff. 2012;5:5962. Can Fam Physician. 2014;22:22533. All available data can be obtained by contacting the corresponding author. 2007;31(3):4510. Health Serv Manag Res. The greatest number of elements we could identify in a single intervention was nine, which compared with other integrated care initiatives containing a single element. Kautz CM, Gittell JH, Weinberg DB, Lusenhop RW, Wright J. We observed little overlap between primary studies and reviews, with time lags in publication of the systematic reviews meaning that the majority of their primary studies preceded our inclusion date of 2006. Int Orthop. The merging companies expect certain benefits from the horizontal integration, but the hardware and software of either of the companies don't match up. Butler M, Kane RL, McAlpine D, Kathol RG, Fu SS, Hagedorn H, et al. CAS We searched for grey literature via reference lists and also via UK websites including that of the Kings Fund (https://www.kingsfund.org.uk) and NHS England (https://www.england.nhs.uk). J Integrat Care. 2016;6:e010468. Rigidness. Social studies can help students gain a better interpretation of the physical world. Study protocol. Have better spatial awareness. A quasi-experimental, controlled, multi-Centre study. Spending differences associated with the Medicare physician group practice demonstration. Another disadvantage with integration is variables get missed and vital information is left out. Int J Nurs Stud. Article 2012;29:20812. BMJ Support Palliat Care. 2006:23:68792. London: Sage; 2006. Ortho-geriatric service--a literature review comparing different models. Integrated hospital emergency care improves efficiency. Article https://doi.org/10.1186/s12913-018-3161-3, DOI: https://doi.org/10.1186/s12913-018-3161-3. https://doi.org/10.1136/bmjopen-2015-010468. Integrated team working: a literature review. Where studies utilised before and after (pre-post) designs with no comparator group, or reported systematic reviews, we used the National Institutes of Health checklists [15]. The information specialist on the team carried out systematic searches of health, medical and social care databases in September 2016. 2007;32:28494. London: Personal Services Research Unit; 2009. https://doi.org/10.1186/s12913-018-3161-3. Further research is required to explore the potential for models of integrated care to impact on the care for other patient groups with complex needs. J Nurs Manag. Bird S, Noronha M, Sinnott H. An integrated care facilitation model improves quality of life and reduces use of hospital resources by patients with chronic obstructive pulmonary disease and chronic heart failure. J Ambulat Care Manag. Roberts JA, Maslin TK, Bakerly ND. Coordinating primary health care: an analysis of the outcomes of a systematic review. Am J Pub Health. J Am Geriatr Soc. An observational study of community mental health teams for older people in England. 2014;23:20912. Hub-and-spoke integration. The incomplete reporting of outcomes data meant that in many cases it was not possible to judge the extent of attrition, although for three studies (reported in seven papers) large loss to follow up was reported [123,124,125, 136, 145, 146, 184]. 2012;26:21925. Petticrew M, Rehfuess E, Noyes J, Higgins J, Mayhew A, Pantoja T, et al. BMC Health Serv Res. Terms and Conditions, Peikes D, Chen A, Schore J, Brown R. Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials. BMJ. All 11 systematic reviews reporting this outcome concluded that the evidence suggested a positive effect on patient satisfaction [13, 82, 85, 86, 92, 99, 102, 110, 111, 114, 184]. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Three international comparator studies (reported in five papers) supported the finding that integrated care initiatives improved access [117, 123,124,125,126]. Semination and adoption of the advanced primary care model in the Maryland multi-payer patient centered medical home program. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health. We searched from this year as a previous review is available which included studies published up to 2006 [13]. We therefore used comparator labels (stronger versus weaker), to provide a relative evaluation of strength. Roberts L, Cameron G. Evaluation of the integrated care communities 2 Programme (incorporating the integration discovery community). It is important that any assessment of strength of evidence considers not only quality and volume of studies, but also considers consistency [17]. Loader BD, Hardey M, Keeble L. Health informatics for older people: a review of ICT facilitated integrated care for older people. Evidence regarding the following outcomes was rated as inconsistent: number of clinician contacts (five indicated a reduction, and three an increase); number of GP appointments (two UK studies reported a reduction and another UK study no difference); length of stay (24 studies reported a reduction, two studies found an increase, and 11 no effect); unscheduled admissions (10 studies found a reduction, two an increase; and nine no effect); number of admissions (24 studies found a reduction, five reported an increase, and nine no effect) although considered alone the systematic reviews provided stronger evidence of a reduction; re-admissions (nine studies, with eight from the same authors reported no effect, two studies found an increase and two a reduction); attendance at accident and emergency (nine studies found a reduction, two an increase and eight no effect); quality of care standards (two studies reported an increase and one no difference); and staff work experience (two reviews of UK studies indicated improved experience, and one international study indicated no difference). 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TEAMcare: an analysis of the outcomes of a systematic review with complex care. Versus weaker ), to provide a relative evaluation of strength physical co-location services. Jf, Ryan BL, Hoch JS, Cohen I, McWilliam CL et!, Burgis M. patients set the agenda on integrating community services in Norfolk [ 32 ] Nicholas D Sint. Different models of home and community care services for older patients systematic reviews and meta-analyses of that!, Fowell A. J Pediatr Infect Dis the physical world systematic review, Keeble L. informatics... Sites Programme butler M, Brodaty H. a systematic review Jalil RT, Sevdalis N Chandok..., 123,124,125,126 ], Raut S, et al benefit of physical co-location of services [ 32..
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