Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols

Erik Baltaxe, Isaac Cano, Carmen Herranz, Anael Barberan-Garcia, Carme Hernandez, Albert Alonso, Maria Jose Arguis, Cristina Bescos, Felip Burgos, Montserrat Cleries, Joan Carles Contel, Jordi de Batlle, Kamrul Islam, Rachelle Kaye, Maarten Lahr, Graciela Martinez-Palli, Felip Miralles, Montserrat Moharra, David Monterde, Jordi PieraJose Rios, Nuria Rodriguez, Reut Ron, Maureen Rutten-van Molken, Tomas Salas, Sebastia Santaeugenia, Helen Schonenberg, Oscar Solans, Gerard Torres, Eloisa Vargiu, Emili Vela, Josep Roca

    OnderzoeksoutputAcademicpeer review

    28 Citaten (Scopus)
    177 Downloads (Pure)

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    BackgroundComprehensive 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) (7.5M 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 (520k 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 (216k inhabitants).MethodsThe 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.DiscussionThe 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 registrationNCT03130283 (date released 04/06/2018), NCT03768050 (date released 12/05/2018), NCT03767387 (date released 12/05/2018).

    Originele taal-2English
    Artikelnummer370
    Aantal pagina's11
    TijdschriftBMC Health Services Research
    Volume19
    DOI's
    StatusPublished - 11-jun.-2019

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