Relevant models and elements of integrated care for multi-morbidity: Results of a scoping review

•Models and elements used for integrated chronic illness care are presented.•Identified elements are structured according to the six WHO health system building blocks.•Most models and elements identified do not explicitly focus on multi-morbidity.•A comprehensive framework better accounting for the...

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Bibliographic Details
Published in:Health policy (Amsterdam) 2018-01, Vol.122 (1), p.23-35
Main Authors: Struckmann, Verena, Leijten, Fenna R.M., van Ginneken, Ewout, Kraus, Markus, Reiss, Miriam, Spranger, Anne, Boland, Melinde R.S., Czypionka, Thomas, Busse, Reinhard, Rutten-van Mölken, Maureen
Format: Article
Language:English
Subjects:
Chronic illnesses
Collaboration
Coordination
Elements
Extraction
Health administration
Health care
Health care policy
Health services
Integrated care
Integrated care programmes
Integrated chronic care
Interdisciplinary aspects
Managed care
Morbidity
Multi-morbidity
Needs assessment
Patient-centered care
Program implementation
Search strategies
Selfmanagement
Social services
Social services delivery
Tests
Theoretical models
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Summary:•Models and elements used for integrated chronic illness care are presented.•Identified elements are structured according to the six WHO health system building blocks.•Most models and elements identified do not explicitly focus on multi-morbidity.•A comprehensive framework better accounting for the complexities resulting from multi-morbidity is needed. In order to provide adequate care for the growing group of persons with multi-morbidity, innovative integrated care programmes are appearing. The aims of the current scoping review were to i) identify relevant models and elements of integrated care for multi-morbidity and ii) to subsequently identify which of these models and elements are applied in integrated care programmes for multi-morbidity. A scoping review was conducted in the following scientific databases: Cochrane, Embase, PubMed, PsycInfo, Scopus, Sociological Abstracts, Social Services Abstracts, and Web of Science. A search strategy encompassing a) models, elements and programmes, b) integrated care, and c) multi-morbidity was used to identify both models and elements (aim 1) and implemented programmes of integrated care for multi-morbidity (aim 2). Data extraction was done by two independent reviewers. Besides general information on publications (e.g. publication year, geographical region, study design, and target group), data was extracted on models and elements that publications refer to, as well as which models and elements are applied in recently implemented programmes in the EU and US. In the review 11,641 articles were identified. After title and abstract screening, 272 articles remained. Full text screening resulted in the inclusion of 92 articles on models and elements, and 50 articles on programmes, of which 16 were unique programmes in the EU (n=11) and US (n=5). Wagner’s Chronic Care Model (CCM) and the Guided Care Model (GCM) were most often referred to (CCM n=31; GCM n=6); the majority of the other models found were only referred to once (aim 1). Both the CCM and GCM focus on integrated care in general and do not explicitly focus on multi-morbidity. Identified elements of integrated care were clustered according to the WHO health system building blocks. Most elements pertained to ‘service delivery’. Across all components, the five elements referred to most often are person-centred care, holistic or needs assessment, integration and coordination of care services and/or professionals, collaboration, and self-management (aim 1). Most
ISSN:0168-8510
1872-6054
DOI:10.1016/j.healthpol.2017.08.008