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dc.contributor.authorBaltaxe, Erik
dc.contributor.authorCano, Isaac
dc.contributor.authorHerranz, Carmen
dc.contributor.authorBarberan-Garcia, A
dc.contributor.authorHernandez, C
dc.contributor.authorAlonso, Albert
dc.contributor.authorBescos, Cristina
dc.contributor.authorBurgos, EF
dc.contributor.authorCleries, Montserrat
dc.contributor.authorContel, Joan Carles
dc.contributor.authorde Batlle, Jordi
dc.contributor.authorIslam, M. Kamrul
dc.contributor.authorKaye, R
dc.contributor.authorLahr, Maarten
dc.contributor.authorMartinez-Palli, G
dc.contributor.authorMonterde, D
dc.contributor.authorRutten-van Mölken, Maureen P M H
dc.contributor.authorRoca, J
dc.PublishedBaltaxe E, Cano I, Herranz C, Barberan-Garcia A, Hernandez C, Alonso A, Bescos, Burgos E, Cleries, Contel, de Batlle J, Islam M. Kamrul, Kaye R, Lahr, Martinez-Palli, Monterde, Rutten-van Mölken MPMH, Roca J. Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols. BMC Health Services Research. 2019;19:370eng
dc.description.abstractBackground: 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.en_US
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.titleEvaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocolseng
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.rights.holderCopyright 2019 The Authorsen_US
dc.source.journalBMC Health Services Research

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