Models of integrated care for multi-morbidity assessed in systematic reviews: a scoping review

BMC Health Services Research

Research

Anke Rohwer¹  Taryn Young¹  Jeannine Uwimana-Nicol²  Ann R. Akiteng³  Jean Berchmans Niyibizi⁴  Charlotte M. Bavuma⁵  Ingrid Toews⁶  John L.Z. Nyirenda⁶  Joerg J. Meerpohl⁷  Tamara Kredo⁸ 

[1] Centre for Evidence-based Health Care, Division Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Centre for Evidence-based Health Care, Division Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;College of Health Sciences, Makerere University, Kampala, Uganda;College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;Kigali University Teaching Hospital, Kigali, Rwanda;Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany;Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany;Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany;South African Medical Research Council, Cochrane South Africa, Cape Town, South Africa;Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;

关键词: Integrated care;    Multi-morbidity;    Chronic diseases;    Non-communicable diseases;    Low- and middle-income countries;    Systematic review;    Collaborative care;   

DOI  :  10.1186/s12913-023-09894-7

 received in 2022-12-12, accepted in 2023-08-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe prevalence of multi-morbidity is increasing globally. Integrated models of care present a potential intervention to improve patient and health system outcomes. However, the intervention components and concepts within different models of care vary widely and their effectiveness remains unclear. We aimed to describe and map the definitions, characteristics, components, and reported effects of integrated models of care in systematic reviews (SRs).MethodsWe conducted a scoping review of SRs according to pre-specified methods (PROSPERO 2019 CRD42019119265). Eligible SRs assessed integrated models of care at primary health care level for adults and children with multi-morbidity. We searched in PubMed (MEDLINE), Embase, Cochrane Database of Systematic Reviews, Epistemonikos, and Health Systems Evidence up to 3 May 2022. Two authors independently assessed eligibility of SRs and extracted data. We identified and described common components of integrated care across SRs. We extracted findings of the SRs as presented in the conclusions and reported on these verbatim.ResultsWe included 22 SRs, examining data from randomised controlled trials and observational studies conducted across the world. Definitions and descriptions of models of integrated care varied considerably. However, across SRs, we identified and described six common components of integrated care: (1) chronic conditions addressed, (2) where services were provided, (3) the type of services provided, (4) healthcare professionals involved in care, (5) coordination and organisation of care and (6) patient involvement in care. We observed differences in the components of integrated care according to the income setting of the included studies. Some SRs reported that integrated care was beneficial for health and process outcomes, while others found no difference in effect when comparing integrated care to other models of care.ConclusionsIntegrated models of care were heterogeneous within and across SRs. Information that allows the identification of effective components of integrated care was lacking. Detailed, standardised and transparent reporting of the intervention components and their effectiveness on health and process outcomes is needed.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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