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Title: Evaluation of integrated care services in Catalonia: population-based and service- based real-life deployment protocols
Author: Baltaxe, Erik
Cano Franco, Isaac
Herranz, Carmen
Barberán García, Anael
Hernández, Carme (Hernández Carcereny)
Alonso, Albert
Arguis, María José
Bescos, Cristina
Burgos, Felip
Cleries, Montserrat
Contel, Joan Carles
de Batlle, Jordi
Islam, Kamrul
Kaye, Rachelle
Lahr, Maarten
Martínez Palli, Graciela
Miralles, Felip
Moharra, Montserrat
Monterde, Davide
Piera, Jordi
Ríos, Jordi
Rodríguez Ávila, Núria
Ron, Reut
van Mölken, Maureen Rutten
Salas, Tomás
Santaeugenia, Sebastià
Schonenberg, Helen
Solans, Óscar
Torres, Gerard
Vargiu, Eloisa
Vela, Emili
Roca Torrent, Josep
Keywords: Malalts crònics
Atenció domiciliària
Chronically ill
Home care services
Issue Date: 11-Jun-2019
Publisher: BioMed Central
Abstract: Background: Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016-2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011-2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation. They reflect different implementation maturity levels. While full coverage of the entire urban health district of Barcelona-Esquerra (520 k inhabitants) is the main aim of home hospitalization, demonstration of sustainability at Hospital Clinic of Barcelona constitutes the core goal of the prehabilitation service. Likewise, full coverage of integrated care services addressed to frail chronic patients is aimed at the city of Badalona (216 k inhabitants). Methods: The population-based analysis, as well as the three service-based protocols, follow observational and experimental study designs using a non-randomized intervention group (integrated care) compared with a control group (usual care) with a propensity score matching method. Evaluation of cost-effectiveness of the interventions using a Quadruple aim approach is a central outcome in all protocols. Moreover, multi-criteria decision analysis is explored as an innovative method for health delivery assessment. The following additional dimensions will also be addressed: i) Determinants of sustainability and scalability of the services; ii) Assessment of the technological support; iii) Enhanced health risk assessment; and, iv) Factors modulating service transferability. Discussion: The current study offers a unique opportunity to undertake a comprehensive assessment of integrated care fostering deployment of services at regional level. The study outcomes will contribute refining service workflows, improving health risk assessment and generating recommendations for service selection. Trials registration: NCT03130283 (date released 04/06/2018), NCT03768050 (date released 12/05/2018), NCT03767387 (date released 12/05/2018).
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It is part of: BMC Health Services Research, 2019, vol. 19, num. 1, p. 370
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ISSN: 1472-6963
Appears in Collections:Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Medicina)

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