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

BMC Family Practice

Research Article

Dirk Ruwaard¹  Rosa Y. Arends²  Inge Boesveld³  Marc A. Bruijnzeels³  Pim P. Valentijn⁴  Hubertus J. M. Vrijhoef⁵ 

[1] Department of Health Services Research, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands;Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands;Jan van Es Institute, Netherlands Expert Centre Integrated Primary Care, Wisselweg 33, CB 1314, Almere, The Netherlands;Jan van Es Institute, Netherlands Expert Centre Integrated Primary Care, Wisselweg 33, CB 1314, Almere, The Netherlands;Scientific Centre for Care and Welfare (Tranzo), Tilburg University, Tilburg, The Netherlands;Scientific Centre for Care and Welfare (Tranzo), Tilburg University, Tilburg, The Netherlands;Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore;Department of Patient and Care, University Hospital Maastricht, Maastricht, The Netherlands;

关键词: Integrated care;    Primary care;    Coordinated care;    Delphi study;    Taxonomy;    Classification;    Delivery of health care;   

DOI  :  10.1186/s12875-015-0278-x

 received in 2015-01-05, accepted in 2015-05-06,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundDeveloping 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.MethodsFirst, 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.ResultsThe 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.ConclusionsThe 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.

【 授权许可】

CC BY   
© Valentijn et al.; licensee BioMed Central. 2015