Systematic review of integrated models of health care delivered at the primary?secondary interface: how effective is it and what determines effectiveness?

Australian Journal of Primary Health
Geoffrey MitchellClaire L Jackson

Abstract

Integrated multidisciplinary care is difficult to achieve between specialist clinical services and primary care practitioners, but should improve outcomes for patients with chronic and/or complex chronic physical diseases. This systematic review identifies outcomes of different models that integrate specialist and primary care practitioners, and characteristics of models that delivered favourable clinical outcomes. For quality appraisal, the Cochrane Risk of Bias tool was used. Data are presented as a narrative synthesis due to marked heterogeneity in study outcomes. Ten studies were included. Publication bias cannot be ruled out. Despite few improvements in clinical outcomes, significant improvements were reported in process outcomes regarding disease control and service delivery. No study reported negative effects compared with usual care. Economic outcomes showed modest increases in costs of integrated primary-secondary care. Six elements were identified that were common to these models of integrated primary-secondary care: (1) interdisciplinary teamwork; (2) communication/information exchange; (3) shared care guidelines or pathways; (4) training and education; (5) access and acceptability for patients; and (6) a viable fund...Continue Reading

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Citations

Oct 27, 2016·Health & Social Care in the Community·Letitia H BurridgeClaire L Jackson
Sep 7, 2016·Australian Journal of Primary Health·Erin TurbittGary L Freed
Jul 12, 2017·International Journal of Care Coordination·Hubertus Jm VrijhoefNick A Guldemond
Apr 11, 2018·Canadian Journal on Aging = La Revue Canadienne Du Vieillissement·Cara L Brown, Verena Menec
May 10, 2017·Australian Health Review : a Publication of the Australian Hospital Association·Claire L JacksonH David McIntyre
Jan 22, 2018·BMJ Supportive & Palliative Care·Geoffrey K MitchellPatsy M Yates
Jan 15, 2019·Australian Journal of Primary Health·Timothy C Kariotis, Keith M Harris
Sep 25, 2018·International Journal of Evidence-based Healthcare·Matthew D StephensonEdoardo C Aromataris
Apr 13, 2019·Health & Social Care in the Community·Linda LeeFrank Molnar
Nov 2, 2019·International Journal for Equity in Health·Pauline DawsonJean Hay-Smith
Nov 15, 2019·Health Policy and Planning·Li-Lin Liang
Oct 1, 2019·International Journal of STD & AIDS·S M BulsaraH Wand
Aug 18, 2020·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Karolina LisyMichael Jefford
Sep 19, 2020·Australian Health Review : a Publication of the Australian Hospital Association·Kimberly BuckMarcus Sellars
Jul 17, 2020·Health & Social Care in the Community·Rachael FrostUNKNOWN PriDem Study project team
Mar 23, 2017·Wiener medizinische Wochenschrift·Isabel Geiger, Claudia Wild
Sep 28, 2017·Australian Journal of Primary Health·Timothy H M ToKate Swetenham
Aug 15, 2017·Primary Health Care Research & Development·Helen P French, Rose Galvin
Dec 4, 2019·BMC Family Practice·Konstantinos TzartzasFriedrich Stiefel
Sep 3, 2019·Australian Journal of Primary Health·Clare Hannan-JonesAllyson Mutch
Jun 13, 2020·Australian Journal of Primary Health·Geoffrey K MitchellAllyson J Mutch
Nov 15, 2017·Australian Journal of Primary Health·Lisa Angus, Pim P Valentijn
Oct 5, 2018·BMC Health Services Research·Bélène PodmoreRebecca Lynch
Oct 13, 2020·International Journal of Integrated Care·John EastwoodDenise De Souza
Dec 19, 2020·International Journal of Integrated Care·Perrin MossTrevor Russell
May 20, 2021·Journal of Paediatrics and Child Health·Sarina TowersKendall Crossen
Jul 6, 2021·International Journal of Integrated Care·Tania CarronIsabelle Peytremann-Bridevaux
Jul 6, 2021·International Journal of Integrated Care·Cloe RawlinsonIngrid Gilles

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