a systematic review

165 Pages·2017·2.51 MB·English

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Baxter, S.K. orcid.org/0000-0002-6034-5495, Johnson, M., Chambers, D. et al. (3 more
authors) (2018) Understanding new models of integrated care in developed countries: a
systematic review. Health Services and Delivery Research, 6 (29). ISSN 2050-4349
https://doi.org/10.3310/hsdr06290
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HEALTH SERVICES AND DELIVERY RESEARCH
VOLUME 6 ISSUE 29 AUGUST 2018
ISSN 2050-4349
Understanding new models of integrated care in
developed countries: a systematic review
Susan Baxter, Maxine Johnson, Duncan Chambers, Anthea Sutton,
Elizabeth Goyder and Andrew Booth
DOI 10.3310/hsdr06290
Understanding new models of
integrated care in developed countries:
a systematic review
Susan Baxter,* Maxine Johnson, Duncan Chambers,
Anthea Sutton, Elizabeth Goyder and Andrew Booth
School of Health and Related Research (ScHARR), University of Sheffield,
Sheffield, UK
*Corresponding author
Declared competing interests of authors: Andrew Booth is a member of the National Institute for
Health Research Complex Review Research Support Unit funding board.
Published August 2018
DOI: 10.3310/hsdr06290
This report should be referenced as follows:
Baxter S, Johnson M, Chambers D, Sutton A, Goyder E, Booth A. Understanding new models of
integrated care in developed countries: a systematic review. Health Serv Deliv Res 2018;6(29).
Health Services and Delivery Research
ISSN 2050-4349 (Print)
ISSN 2050-4357 (Online)
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DOI: 10.3310/hsdr06290 HEALTH SERVICES AND DELIVERY RESEARCH 2018 VOL. 6 NO. 29
Abstract
Understanding new models of integrated care in developed
countries: a systematic review
Susan Baxter,* Maxine Johnson, Duncan Chambers, Anthea Sutton,
Elizabeth Goyder and Andrew Booth
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
*Corresponding author
ABSTRACT
appointments and waiting times. Evidence was inconsistent regarding other outcomes and system-wide
impacts such as levels of activity and costs. There was an indication that new models have particular
potential with patients who have complex needs.
Limitations: Defining new models of integrated care is challenging, and there is the potential that our
study excluded potentially relevant literature. The review was extensive, with diverse study populations and
interventions that precluded the statistical summary of effectiveness.
Conclusions: There is stronger evidence that new models of integrated care may enhance patient
satisfaction and perceived quality and increase access; however, the evidence regarding other outcomes is
unclear. The study recommends factors to be considered during the implementation of new models.
Future work: Links between elements of new models and outcomes require further study, together with
research in a wider variety of populations.
Study registration: This study is registered as PROSPERO CRD37725.
Funding: The National Institute for Health Research Health Services and Delivery Research programme.
vi
NIHR Journals Library www.journalslibrary.nihr.ac.uk
DOI: 10.3310/hsdr06290 HEALTH SERVICES AND DELIVERY RESEARCH 2018 VOL. 6 NO. 29
Contents
List of tables ix
List of figures xi
List of boxes xiii
List of supplementary material xv
Glossary xvii
List of abbreviations xix
Plain English summary xxi
Scientific summary xxiii
Chapter 1 Introduction and background 1
Rationale 1
Objectives 2
Research questions 2
Changes from the protocol 2
Chapter 2 Methods 3
Identification of literature 3
Search strategy 3
Sources searched 3
Study selection 4
Inclusion and exclusion criteria 4
The screening process 4
The data collection process 5
Data items 5
Risk of bias in individual studies 5
Risk of bias and strength of evidence across studies 6
Summary measures 7
Synthesis of results 7
Narrative synthesis 7
Logic model framework 8
Applicability framework 9
Protocol and registration 10
Patient and public involvement 10
Stakeholder involvement 10
Chapter 3 Results 13
Study selection 13
Type of studies excluded 13
Study characteristics 14
Risk of bias within studies 15
© Queen’s Printer and Controller of HMSO 2018. This work was produced by Baxter et al. under the terms of a commissioning contract issued by the Secretary of State for Health
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be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science
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