Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review

International Journal of Integrated Care

卷:21

Walter Cullen¹  John Broughan²  Geoff McCombe²  Thomas Dennehy²  Áine Carroll²  Áine Harrold²  Ronan Fawsitt²  Sara Murtagh²  Mary Casey³ 

[1] Ireland East Hospital Group, Dublin;

[2] School of Medicine, University College Dublin;

[3] School of Nursing Midwifery and Health Systems, University College Dublin;

关键词: integrated care;    primary care;    secondary care;    scoping review;    chronic disease;   

DOI  :  10.5334/ijic.5508

来源: DOAJ

【 摘 要 】

Background: In Ireland, as in many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of chronic disease. Integrated care is an approach to healthcare systems delivery that aims to minimise fragmentation of patient services and improve care continuity. To this end, how best to integrate primary and secondary care is a challenge. This paper aims to undertake a scoping review of empirical work on the integration of primary and secondary care in relation to chronic disease management. Methods: A search was conducted of ‘PubMed’, ‘Cochrane Library’ and ‘Google Scholar’ for papers published between 2009–2019 using Arksey and O’Malley’s framework for conducing scoping reviews. Results: Twenty-two studies were included. These reported research from a wide range of healthcare systems (most commonly UK, Australia, the Netherlands), adopted a range of methodologies (most commonly randomised/non-randomised controlled trials, case studies, qualitative studies) and among patients with a range of chronic conditions (most commonly diabetes, COPD, Parkinson’s disease). No studies reported on interventions to address the needs of whole populations. Interventions to enhance integration included multidisciplinary teams, education of healthcare professionals, and e-health interventions. Among the effectiveness measures reported were improved disease specific outcomes, and cost effectiveness. Conclusion: With healthcare systems increasingly recognising that integrated approaches to patient care can enhance chronic disease management, considerable literature now informs how this can be done. However, most of the research published has focussed on specific diseases and their clinical outcomes. Future research should focus on how such approaches may improve health outcomes for populations as a whole.

【 授权许可】

Unknown