2009;361:23013. London: National Health Service England; 2014. 2007;298:262333. The impact of integrated care on direct nursing home care. Health Policy. BMJ Support Palliat Care. Article 2013;88:18494. Am J Pub Health. Int J Social Welfare. Letton C, Cheung C, Nordin A. Instructional time spent on elementary social studies has waned in the context of high stakes testing of math and English Language Arts. In view of this challenge, we used strength of evidence ratings to summarise where greater or lesser certainty existed in the literature, considering quality, volume and consistency of the evidence identified. Eur J Obs Gynecol Reprod Biol. Int J Health Care Qual Assur. 2009;7:6174. Hebert R, Raiche M, Dubois MF, Gueye NR, Dubuc N, Tousignant M. Impact of PRISMA, a coordination-type integrated service delivery system for frail older people in Quebec (Canada): a quasi-experimental study. Online sources were searched for UK grey literature, and citation searching, and manual reference list screening were also carried out. 2013;18:110. 2014;14:377. Lancet Neurol. Cohen E, Lacombe-Duncan A, Spalding K, MacInnis J, Nicholas D, Narayanan U, et al. Provided by the Springer Nature SharedIt content-sharing initiative. Last week, we wrote a blog post on the benefits of integrating genomics into clinical trials, such as improved methods for patient stratification, contributing to genetic research and accounting for sources of variability.. The included UK studies fared better in regard to completion of outcome assessment, and reporting was assessed as being accurate for all but one [44] which had insufficiently discussed the study limitations. Bird SR, Noronha M, Kurowski W, Orkin C, Sinnott H. Integrated care facilitation model reduces use of hospital resources by patients with pediatric asthma. UK-only evidence indicated that patient waiting time and outpatient appointments may be reduced, and patient wishes at end of life are met more often (although inconsistency or lack of evidence for these effects was found in the international literature). writing, grammar, social studies, and science" (p.11). 2008;63:3217. 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. Arch Gerontol Geriatr. Advantages/Disadvantages One disadvantage of theory integration the possibility of the wrong mixture of theories by criminologist which could increase the odds of a person gravitating towards criminality increase (Frame, 2009). J Psychiat Mental Health Nurs. J Health Care Poor Underserved. J Interprof Care. Systematic reviews have typically sought clear intervention-outcome effects from gold standard randomised experimental studies. PubMedGoogle Scholar. MacLean A, Fuller RM, Jaffrey EG, Hay AJ, Ho-Yen DO. BMC Health Serv Res. Integrated models of care delivery for the frail elderly: international perspectives. 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. Health Aff. However, the wide variety of models of integrated care, and multiple and complex elements contained therein, together with the heterogeneity of outcomes measured, contra-indicated the use of summary statistics. Can Fam Physician. 2009;35:8292. Integrating mental health services for older people in England - from rhetoric to reality. Generally participants recruited appeared to be representative of the population of interest, although often it was difficult to ascertain the recruitment process. 2006;25:542. Quality assessment was based on the hierarchy of study design, together with use of a variety of checklists for each study type. Cite this article. BMC Health Serv Res. Homer CJ, Klatka K, Romm D, Kuhlthau K, Bloom S, Newacheck P, et al. Ortho-geriatric service--a literature review comparing different models. Johansson G, Eklund K, Gosman-Hedstrom G. Multidisciplinary team, working with elderly persons living in the community: a systematic literature review. Ten key principles for successful health systems integration. BMC Health Services Research London: National Audit . 2009;301:60318. Google Scholar. Tytler argues that one disadvantage of an integrated approach is that one or the other learning area is trivialized. 2008;6:78110. Roberts L, Cameron G. Evaluation of the integrated care communities 2 Programme (incorporating the integration discovery community). SA HealthPlus: a controlled trial of a statewide application of a generic model of chronic illness care. BMC Health Serv Res. Holistic is one of the advantages that is used during . Only a third were judged to have clearly described the intervention and its delivery, and none reported taking measures at multiple time points prior to the intervention. Milbank Q. The effect of policy on end-of-life care practice within nursing care homes: a systematic review. Boult C, Reider L, Frey K, et al. Mackie S, Darvill A. . Figure2 summarises the country of origin for the different types of study design. 2007;20(23):195214. J Health Serv Res Policy. Fagan P, Schuster A, Boyd C, Marstellar J, Griswold M, Murphy S. Chronic care improvement in primary care: evaluation of an integrated pay-for-performance and practice-based care coordination program among elderly patients with diabetes. J Am Med Assoc. Critics of the integrated theories argue that theorist need to take caution when developing these theories because of high potential of contradictory, creation of micro situational, pitting against one another, and lack of empirical validity (Tibbetts, Continue Reading Check Writing Quality You May Also Find These Documents Helpful jparshall@americanprogress.org. Our evaluation therefore draws on work by Hoogendoom [17], together with principles from the GRADE and CERQUAL rating schemes [16, 18], and our work from a previous systematic review with diverse evidence [19] to indicate a rating of strength (certainty) for each reported outcome across the included studies. Health and social care integration. Six features of Medicare coordinated care demonstration programs that cut hospital admissions of high-risk patients. J Am Med Assoc. 2009;150:17887. Mention and explain the types of Economic Integration; State the advantages of economic integration; Identify the disadvantages of economic integration. J Diabetes. 2011;19:226. Models of integrated care encompass diverse initiatives that aim to improve integration of care across healthcare and between health and social care services. We explored whether there were any particular trends in the data in terms of outcomes for initiatives delivered in differing settings, and found variable findings for each context. The rating of very limited evidence (insufficient studies) was assigned to the following outcomes: prescribing rates; access to resources; time spent in accident and emergency department; the number of incidents/complaints; and identification of unmet need. A systematic review published in 2017 examined initiatives to move care from hospitals to the community, and similarly concluded that anticipated cost savings could not be assumed [7]. Some of the arguments for integrative curriculum include: There is not enough time in the day to teach everything in isolation. Wedel R, Kalischuk RG, Patterson E, Brown S. Turning vision into reality: successful integration of primary healthcare in Taber, Canada. 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]. London J Prim Care. 2011;15(2):3943. 1) Enhance the Competitive Advantage. Aiken LS, Butner J, Lockhart CA, Volk-Craft BE, Hamilton G, Williams FG. Eur J Heart Failure. North West London integrated care pilot evaluation: report on work Programme 3. Hogg W, Lemelin J, Dahrouge S, Liddy C, Amstrong CD, Legault F, et al. https://doi.org/10.1016/j.jval.2014.08.259. Ettner SL, Kotlerman J, Afifi A, Vazirani S, Hays RD, Shapiro M, et al. Article It is argued that increased service integration will enable the achievement of a financially sustainable health and social care system in the NHS by 2020. Appendix S4. Nicholson C, Jackson C, Marley J. Janse B, Huijsman R, de Kuyper R Fabbricotti I. Epstein AM, Jha AK, Orav EJ, Liebman DL, Audet A, Zezza MA, et al. Martinussen M, Adolfsen F, Lauritzen C, Richardson A. Battersby M, Harvey P, Mills PD, Kalucy E, Pols RG, Frith PA, et al. J Pediatr Infect Dis. JAMA. 2011;25(Suppl 2):13846. We also examined evidence relating to wider impacts across the whole of a healthcare system. Brit J Infect Control. Counsell SR, Callahan CM, Tu W, Buttar A, Stump T, et al. These studies evaluated multi-disciplinary teams, general service re-design, or integration of hospital and community services. https://doi.org/10.1136/bmj.b2700. Figure4 summaries the types of patients and conditions in the studies included in the review. 2006;295:214857. Stampa M, Vedel I, Buyck J, Lapointe L, Bergman H, Beland F, et al. J Ambulat Care Manag. J Am Geriatr Soc. Hockley J, Watson J, Oxenham D, Murray SA. Hammar T, Rissanen P, Perl M. The cost-effectiveness of integrated home care and discharge practice for home care patients. Brawer PA, Martielli R, Pye PL, Manwaring J, Tierney A. St. Louis initiative for integrated care excellence (SLI(2)CE): integrated-collaborative care on a large scale model. Integrated care pathway for Clostridium difficile helps patient management. Barnett J, Vasileiou K, Djemil F, Brooks L, Young T. Understanding innovators experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study. We therefore used comparator labels (stronger versus weaker), to provide a relative evaluation of strength. 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. For example an increase in service usage may be positive for patients or the service, but may also be negative in terms of costs or detrimental effect on other services. J Integrated Care. We therefore adopted an approach drawing on work by Pawson, [11] which stresses that both rigour and relevance are important when scrutinising complex outcome patterns. A cost comparison. 2010;28:17587. Kautz CM, Gittell JH, Weinberg DB, Lusenhop RW, Wright J. Prospero registration number: 42016037725. See Fig. 2006;26:917. Lyon D, Miller J, Pine K. The Castlefields integrated care model: the evidence summarised. Evidence was rated as either inconsistent or limited regarding all other outcomes reported, including system-wide impacts on primary care, secondary care, and health care costs. PubMed Central Tucker S, Baldwin R, Hughes J, Benbow SM, Barker A, Burns A, et al. In line with Cochrane recommendation we did not score elements, and instead provided a narrative rather than numerical indication of quality [14]. 2015;105:6224. 2015;10:e0132340. Coordinate my care: a clinical service that coordinates care, giving patients choice and improving quality of life. Brokel JM, Harrison MI. The receiver and sender of data are coupled together with no other software program serving as an intermediary. Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis. Prim Health Care Res Develop. Health Aff. 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. Other iterative searching techniques were also employed, including hand searching of reference lists of primary studies and other reviews. 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. J Obstet Gynaecol. statement and Matern Child Health J. Int J Care Path. 2014;6:819. Psychiatr Quart. 2007;3:8095. Blinding of participants and personnel was also limited or not possible, with only four studies achieving this [30, 31, 49, 72]. 2009;28(2):32333. In exploring consistency as well as volume when assessing strength of evidence, we have sought to some extent to mitigate this limitation. 2013;27:20920. The effects of an integrated care intervention for the frail elderly on informal caregivers: a quasi-experimental study. London: Personal Services Research Unit; 2009. https://doi.org/10.1186/s12913-018-3161-3. Jack BW, Chetty VK, Anthony D, Greenwald JL, Sanchez GM, Johnson AE, et al. 2011;15:11108. Janse B, Huijsman R, Fabbricotti I. Quality of integrated care for patients with nonsmall cell lung cancer: variations and determinants of care. 2014;14:140. J Healthcare Qual. Additional file 2: Table S1 details the number of studies reporting each outcome, with each study (or papers from the same study) represented by either a plus + meaning that the study reported an increase for this outcome, or a plus/minus sign meaning that the study reported no significant change for this outcome, or a minus sign - meaning that the study reported a reduction for this outcome. Association between Medicare accountable care organization implementation and spending among clinically vulnerable beneficiaries. Service evaluation of an integrated assessment and treatment service for people with intellectual disability with behavioural and mental health problems. The potentially positive outcome of increasing ease of access for patients, also offers contradictory effects. J Am Geriatr Soc. Spending differences associated with the Medicare physician group practice demonstration. The effectiveness of inter-professional working for older people living in the community: a systematic review. London: Nuffield Trust; 2017. 5 Pages. Int J Health Serv : planning, administration, evaluation. (Ray, 2009) Homeschooled children tend to be more participative in other activities outside academics. What are the disadvantages of using an integrated approach? After independent screening and discussion of the first 5% of the database to establish agreement, further screening was carried out by a single reviewer, with checking of a 10% sample by other team members. We included studies reporting any outcome relating to the delivery of services (effectiveness or efficiency or quality) and/or the effect on patients and staff delivering services. Pineault R, Borges Da Silva R, Prud'homme A, Fournier M, Couture A, Provost S, et al. Case management for elderly patients at risk of hospital admission: a team approach. Triple aim in Kinzigtal, Germany: improving population health, integrating health care and reducing costs of care -- lessons for the UK? Kent P, Chalmers Y. Completed quality appraisals. Theodoridou A, Hengartner M, Gairing S, Jager M, Ketteler D, Kawohl W, et al. , Watson J, Pine K. the Castlefields integrated care on direct nursing home care and costs... ( incorporating the integration discovery community ) SL, Kotlerman J, Pine K. the integrated... Appeared to be more participative in other activities outside academics other software program serving as an intermediary Prud'homme a et. Ortho-Geriatric service -- a literature review comparing different models, Butner J, Pine the! Integrated care pathway for Clostridium difficile helps patient management et al of life multi-disciplinary,... 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