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Exploring improvement plans of fourteen European integrated care sites for older people with complex needs

Stoop, Annerieke, De Bruin, Simone R., Wistow, Gerald, Billings, Jenny, Ruppe, Georg, Leichsenring, Kai, Obermann, Konrad, Baan, Caroline A., Nijpels, Giel (2019) Exploring improvement plans of fourteen European integrated care sites for older people with complex needs. Health Policy, 123 (12). pp. 1135-1154. ISSN 0168-8510. (doi:10.1016/j.healthpol.2019.09.009) (KAR id:76772)

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Abstract

Integrated care programmes are increasingly being put in place to provide care to older people living at home. However, knowledge about further improving integrated care is limited. In fourteen integrated care sites in Europe, plans to improve existing ways of working were designed, implemented and evaluated to enlarge the understanding of what works and with what outcomes when improving integrated care. This paper provides insight into the existing ways that the sites were working with respect to integrated care, their perceived difficulties and their plans for working towards improvement. The seven components of the Expanded Chronic Care Model provided a conceptual framework for describing the fourteen sites. Although sites were spread across Europe and differed in basic characteristics and existing ways of working, a number of difficulties in delivering integrated care were similar. Existing ways of working and improvement plans mostly focused on three components of the Expanded Chronic Care Model: delivery system design; decision support; self-management. Two components were represented less frequently in existing ways of working and improvement plans: building healthy public policy; building community capacity. These findings suggest that broadly-based prevention efforts, population health promotion and community involvement remain limited. From the Expanded Chronic Care Model perspective, therefore, opportunities for improving integrated care outcomes may continue to be restricted by the narrow focus of developed improvement plans.

Item Type: Article
DOI/Identification number: 10.1016/j.healthpol.2019.09.009
Uncontrolled keywords: Older people, integrated care, expanded chronic care model, broadly-based prevention
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Meg Dampier
Date Deposited: 25 Sep 2019 09:49 UTC
Last Modified: 11 Nov 2020 09:41 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/76772 (The current URI for this page, for reference purposes)
Billings, Jenny: https://orcid.org/0000-0002-5660-9478
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