Please use this identifier to cite or link to this item:
https://hdl.handle.net/2445/190932
Title: | Prospective cohort study for assessment of integrated care with a triple aim approach: hospital at home as use case |
Author: | Herranz, Carmen González Colom, Rubèn Baltaxe, Erik Seijas, Nuria Asenjo, Maria Hoedemakers, Maike Nicolás, David Coloma, Emmanuel Fernández-Solà, J. (Joaquim) Vela, Emili Cano Franco, Isaac Rutten-van Mölken, Maureen Roca Torrent, Josep Hernandez, Carme |
Keywords: | Atenció domiciliària Assistència hospitalària Medicina personalitzada Serveis d'infermeria Malalties cròniques Home care services Hospital care Personalized medicine Nursing services Chronic diseases |
Issue Date: | 7-Sep-2022 |
Publisher: | BioMed Central |
Abstract: | Background: Applicability of comprehensive assessment of integrated care services in real world settings is an unmet need. To this end, a Triple Aim evaluation of Hospital at Home (HaH), as use case, was done. As ancillary aim, we explored use of the approach for monitoring the impact of adoption of integrated care at health system level in Catalonia (Spain). Methods: Prospective cohort study over one year period, 2017-2018, comparing hospital avoidance (HaH-HA) with conventional hospitalization (UC) using propensity score matching. Participants were after the first episode directly admitted to HaH-HA or the corresponding control group. Triple Aim assessment using multiple criteria decision analysis (MCDA) was done. Moreover, applicability of a Triple Aim approach at health system level was explored using registry data. Results: HaH-HA depicted lower: i) Emergency Room Department (ER) visits (p < .001), ii) Unplanned re-admissions (p = .012); and iii) costs (p < .001) than UC. The weighted aggregation of the standardized values of each of the eight outcomes, weighted by the opinions of the stakeholder groups considered in the MCDA: i) enjoyment of life; ii) resilience; iii) physical functioning; iv) continuity of care; v) psychological wellbeing; (vi) social relationships & participation; (vii) person-centeredness; and (viii) costs, indicated better performance of HaH-HA than UC (p < .05). Actionable factors for Triple Aim assessment of the health system with a population-health approach were identified. Conclusions: We confirmed health value generation of HaH-HA. The study identified actionable factors to enhance applicability of Triple Aim assessment at health system level for monitoring the impact of adoption of integrated care. Registration: ClinicalTrials.gov (26/04/2017; NCT03130283). Keywords: Chronic care, Health Delivery Assessment, Health Services Research, Hospital at Home, Implementation Science, Multiple Criteria Decision Analysis, Triple Aim |
Note: | Reproducció del document publicat a: https://doi.org/10.1186/s12913-022-08496- |
It is part of: | BMC Health Services Research, 2022, vol. 22, p. 1313-1145 |
URI: | https://hdl.handle.net/2445/190932 |
Related resource: | https://doi.org/10.1186/s12913-022-08496- |
ISSN: | 1472-6963 |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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