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

AUTHORS

Annerieke Stoop and Simone R. de Bruin, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, (the Netherlands)

Gerald Wistow, Personal Social Services Research Unit, Department of Social Policy, London School of Economics and Political Science (United Kingdom)

Jenny Billings, Centre for Health Service Studies, University of Kent (United Kingdom)

Kai Leichsenring, Austrian Interdisciplinary Platform on Ageing (ÖPIA) and European Centre for Social Welfare Policy and Research (Austria)

Georg Ruppe, Austrian Interdisciplinary Platform on Ageing (ÖPIA) (Austria)

Konrad Obermann, Mannheim Institute of Public Health (MIPH), Heidelberg University (Germany)

Caroline A. Baan, Scientific Center for Transformation in Care and Welfare (Tranzo), University of Tilburg (the Netherlands)

Giel Nijpels, Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam (the Netherlands)

PUBLICATION YEAR

2019

PUBLISHED IN

Health Policy

CITATION

Stoop, A., de Bruin, S.R., Wistow, G. et al. (2019). Exploring improvement plans of fourteen European integrated caresites for older people with complex needs. Health Policy, 123(12), 1135-54, https://doi.org/10.1016/j.healthpol.2019.09.009

DESCRIPTION

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.

This article is a result of the SUSTAIN project which was funded under Horizon 2020 – the Framework Programme for Research and Innovation (2014–2020) from the European Commission under grant agreement No. 634144. The content of this paper reflects only the authors’ views. The European Union is not liable for any use that may be made of the information contained herein.