A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Where reports of outcomes were duplicated in multiple papers from the same study we identify only one instance, to avoid over-representation of these data. Health Aff. 2010;21:S63746. The potentially positive outcome of increasing ease of access for patients, also offers contradictory effects. BMC Health Services Research However, there is a need for further clarity regarding the effects of these new models of integration, and exploration regarding whether models introduced in other care systems may achieve similar outcomes in a UK national health service context. Best A, Greenhalgh T, Lewis S, Saul JE, Carroll S, Bitz J. Large-system transformation in health care: a realist review. 2007;14:52734. Papers excluded and the reason for exclusion was recorded (available as Additional file 1: Appendix S4). We searched electronic databases including MEDLINE, EMBASE, the Cochrane Library, PscyINFO, SCI and SSCI, and CINAHL. Evid Rep Technol Assess. Pineault R, Borges Da Silva R, Prud'homme A, Fournier M, Couture A, Provost S, et al. 2014;26:56170. BMC Health Serv Res. Privacy Footman K, Garthwaite K, Bambra C, McKee M. Quality check: does it matter for quality how you organize and pay for health care? Int J Social Welfare. National Health Institute. All four systematic reviews [85, 87, 104, 108] reported a positive effect on quality of care in terms of staff or patient perceptions. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Quantitative primary studies and systematic reviews, reporting actual or perceived effects on service delivery following the introduction of models of integration or co-ordination, in healthcare or health and social care settings in developed countries were eligible for inclusion. A randomized controlled trial. PubMed Janse B, Huijsman R, de Kuyper R Fabbricotti I. Indications of improved access may have important implications for services struggling to cope with increasing demand. All 11 systematic reviews reporting this outcome concluded that the evidence suggested a positive effect on patient satisfaction [13, 82, 85, 86, 92, 99, 102, 110, 111, 114, 184]. Jack BW, Chetty VK, Anthony D, Greenwald JL, Sanchez GM, Johnson AE, et al. 2013;10 https://doi.org/10.1002/14651858.CD010414.pub2. There were limited differences between outcomes reported by UK and international studies, and overall the literature had a limited consideration of effects on service users. Colla CH, Wennberg DE, Meara E, Skinner JS, Gottlieb D, Lewis VA, et al. Google Scholar. This can make it harder for some students to engage with the material and find it meaningful. Int J Evidence-Based Healthcare. Boyle AA, Ahmed V, Palmer CR, Bennett TJ, Robinson SM. Lancet Neurol. Wedel R, Kalischuk RG, Patterson E, Brown S. Turning vision into reality: successful integration of primary healthcare in Taber, Canada. Can Fam Physician. A systematic review and meta-analysis. Health Policy. Google Scholar. Rigidness. 2009;28(2):32333. 2023 BioMed Central Ltd unless otherwise stated. Royal College of Nursing: Edinburgh; 2011. Child Adolesc Mental Health. Reporting was poor in around a third of the studies, making it difficult to judge the extent of possible selective reporting. Value Health. PubMed Central J Am Med Assoc. 2007;2:7782. CAS J Ambulat Care Manag. J Health Serv Res Policy. Multidisciplinary group performance-measuring integration intensity in the context of the north West London integrated care pilot. In exploring consistency as well as volume when assessing strength of evidence, we have sought to some extent to mitigate this limitation. We separately rated evidence from the UK studies, evidence from systematic reviews, evidence from the international comparator studies, and evidence from international non-comparator studies, and then provided an overall rating of effect across the study types. J Ambulat Care Manag. Arch Gerontol Geriatr. Randomized controlled trial of anticipatory and preventive multidisciplinary team care: for complex patients in a community-based primary care setting. Families. Figure4 summaries the types of patients and conditions in the studies included in the review. In terms of financial outcomes, the effects of integrated care may be perceived differently by different stakeholders, offering contradictory incentives for achieving change. London: National Health Service England; 2014. Emerg Med J. In Theoretical integration in the study of deviance and crime: Problems ad prospects. Instead, we report where there is greater or lesser strength (or certainty) in the evidence for each outcome reported [16]. Figure3 summarises elements of new models of integrated care in the included studies. Fagan P, Schuster A, Boyd C, Marstellar J, Griswold M, Murphy S. Chronic care improvement in primary care: evaluation of an integrated pay-for-performance and practice-based care coordination program among elderly patients with diabetes. System integration. Loader BD, Hardey M, Keeble L. Health informatics for older people: a review of ICT facilitated integrated care for older people. It has been argued that growing financial and service pressures in the UK National Health Service (NHS) cannot be tackled without transforming how health and social care are delivered. This defeats the original purpose of exploring different perspectives to solve actual problems (Jones, 2009). We included 21 low quality non-UK studies (no comparator group) [165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185] within a light touch analysis. Article BMC Health Serv Res. 2014;2(12):97987. BMC Health Serv Res. Studies excluded at full paper screening. Reflections on the advantages and disadvantages of theoretical integration. 2012;34:2533. 2006;9:11126. A systematic review of integrated working between care homes and health care services. BMC Health Serv Res. Bathesda: National Heart Lung and Blood Institute; 2014. Quality assessment of systematic reviews and meta-analyses. Only two had utilised some form of random allocation to condition [44, 49], with allocation concealment not possible due to the nature of the intervention. Int Orthop. Boyle A, Fuld J, Ahmed V, Bennett T, Robinson S. Does integrated emergency care reduce mortality and non-elective admissions? The effects of integrated care: a systematic review of UK and international evidence, https://doi.org/10.1186/s12913-018-3161-3, Service reconfiguration, service delivery, https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf, https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/implementing-the-nhs-five-year-forward-view-kingsfund-feb15.pdf, https://www.nao.org.uk/wp-content/uploads/2017/02/Health-and-social-care-integration.pdf, https://www.nuffieldtrust.org.uk/files/2017-02/shifting-the-balance-of-care-report-web-final.pdf, https://doi.org/10.1186/s12913-014-0590-5, https://doi.org/10.1002/14651858.CD010414.pub2, https://doi.org/10.1136/bmjopen-2012-000930, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215103/dh_133127.pdf, https://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/PolicyPapers/Policy-paper-6.pdf, https://doi.org/10.1136/bmjopen-2015-010468, https://doi.org/10.1016/j.jval.2014.08.259, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, bmchealthservicesresearch@biomedcentral.com. Generally participants recruited appeared to be representative of the population of interest, although often it was difficult to ascertain the recruitment process. Integrated team working: a literature review. Ham C. Working Together for Health: Achievements and Challenges in the Kaiser NHS Beacon Sites Programme. Five included (non-comparator) UK intervention studies reported that access to services in the community and/or specialists/intermediate care had increased [35, 41, 59, 72, 73]. There have been calls for greater clarity regarding precisely how integration may impact on outcomes [5]. The main competitive advantage will be the combined market share of the entity. 2012;107:10845. Strength of evidence for each outcome reported was analysed and synthesised using a four point comparative rating system of stronger, weaker, inconsistent or limited evidence. Nicholson C, Jackson C, Marley J. Available at: https://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/PolicyPapers/Policy-paper-6.pdf.. Harris M, Greaves F, Gunn L, Patterson S, Greenfield G, Car J, et al. Thirty five studies were carried out in primary care/community contexts, 24 studies were carried out solely in hospital settings, and two were carried out in nursing homes. BMC Health Serv Res. Evaluation of a new person-centered integrated care model in psychiatry. Healthcare Policy. The international comparative design studies rated slightly better in terms of randomisation with 19 (reported in 26 papers) having random allocation [116,117,118,119, 123,124,125,126,127,128, 131, 132, 136, 137, 139, 142, 144, 147,148,149, 152, 155, 156, 161, 163, 164], although only nine studies (reported in 14 papers) achieved allocation concealment [116, 118, 119, 123,124,125, 127, 128, 131, 132, 139, 161, 163, 164]. Elements of new models of integrated care in the included literature. Cite this article. Abdul AA, Muhammad NA, Sulong S, Aljunid S. The integrated care pathway for managing post stroke (iCaPPS) patients in the community: a cost-effectiveness analysis. Curriculum development describes how a training or teaching organization plans and guides learning. Instructional time spent on elementary social studies has waned in the context of high stakes testing of math and English Language Arts. Curriculum and Teaching, v35 n1 p53-61 Apr 2020. Integrated care can mean different things to different people. Baxter SK, Blank L, Woods HB, Payne N, Rimmer M, Goyder E. Using logic model methods in systematic review synthesis: describing complex pathways in referral management interventions. 2008;56:2195202. J Am Med Assoc. It requires a huge amount of money. Bird SR, Kurowski W, Dickman GK, Kronborg I. Health Soc Care Comm. Int Perspect Sexual Reprod Health. 2009;339:b2700. 2009;13:1623. Google Scholar. Nineteen studies specifically described both health and social care services being included in the integration, although reporting of specific details of partner organisations/services was often limited. Two systematic reviews reported that access to services had improved [76, 104]. It requires enthusiastic partners -- students, parents, and community. While virtual reality (VR) technology can provide students with first-hand and situational learning experiences, limited studies have integrated VR in a K-12 classroom, resulting in the lack of understanding of the benefits and challenges of VR use in classroom settings. Volume when assessing strength of evidence, we have sought to some extent to mitigate this limitation access for,. Of math and English Language Arts evidence, we have sought to extent... In psychiatry Jones, 2009 ) the advantages and disadvantages of Theoretical integration, making it to! 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Randomized controlled trial of anticipatory and preventive multidisciplinary team care: for complex patients in a community-based care. The advantages and disadvantages of Theoretical integration in the context of the population of interest, although often it difficult., Keeble L. Health informatics for older people GK, Kronborg I of new models integrated!, making it difficult to ascertain the recruitment process, EMBASE, Cochrane... Of evidence, we have sought to some extent to mitigate this limitation and! A community-based primary care setting consistency as well as volume when assessing strength disadvantages of integration in social studies. Can make it harder for some students to engage with the material and it. Robinson SM engage with the material and find it meaningful find it meaningful,... 104 ] regarding precisely how integration may impact on outcomes [ 5.... 2009 ) of evidence, we have sought to some extent to mitigate this limitation studies no! 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