Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

International Journal of Integrated Care

Volumn 13, Issue JANUARY - MARCH 2, 2013, Pages

  Stewart, Michael J ^a   Georgiou, Andrew ^a   Westbrook, Johanna I ^a  

^a UNIVERSITY OF NEW SOUTH WALES   (Australia)

Author keywords

Aged care; Canada; Integrated care; Integrated delivery systems; Literature review; PRISMA

Indexed keywords

EID: 84883037380     PISSN: None     EISSN: 15684156     Source Type: Journal    
DOI: 10.5334/ijic.963     Document Type: Article

References (71)

1. Burns LR, Pauly MV. Integrated delivery networks: a detour on the road to integrated health care? Health affairs (Project Hope) 2002;21(4):128.
2. Hebert R. Functional decline in old age. Canadian Medical Association Journal 1997;157(8):1037-45.
3. Reed J, Cook G, Childs S, McCormack B. A literature review to explore integrated care for older people. International Journal of Integrated Care [Serial online] 2005 Jan 14;5. [cited 2013 Jan 26]. Available from http://www.ijic.org. URN:NBN:NL:UI:10-1-100361.
4. Productivity Commission. Caring for older Australians. Canberra: Commonwealth of Australia; 2011.
5. World Health Organisation (WHO). Integrated health services: what and why? Technical Brief No 1. Geneva: WHO; 2008.
6. Organisation for Economic Cooperation and Development (OECD). Long-term care for older people. Paris: OECD Publishing; 2005.
7. Kodner DL, Spreeuwenberg C. Integrated care: meaning, logic, applications, and implications-a discussion paper. International Journal of Integrated Care [Serial online] 2002 Nov 14;2. [cited 2013 Jan 26]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-100309.
8. Curry N, Ham C. Clinical and service integration: the route to improved outcomes. London: The King's Fund; 2010.
9. Hebert R, Durand PJ, Dubuc N, Tourigny A, The PRISMA Group. Frail elderly patients: new model for integrated service delivery. Canadian Family Physician 2003;49:992-7.
10. Bodenheimer T. Long-term care for frail elderly people-the On Lok model. New England Journal of Medicine 1999;341(17):1324-8.
11. Eng C, Pedulla J, Eleazer GP, McCann R, Fox N. Program of All-inclusive Care for the Elderly (PACE): an innovative model of integrated geriatric care and financing. Journal of the American Geriatrics Society 1997;45(2):223.
12. Leutz WN, Greenlick M, Ervin S, Feldman E, Malone J. Adding long-term care to Medicare: The Social HMO Experience. Journal of Aging & Social Policy 1991;3(4):69.
13. Béland F, Bergman H, Lebel P, Dallaire L, Fletcher J, Tousignant P, et al. Integrated services for frail elders (SIPA): a trial of a model for Canada. Canadian Journal on Aging 2006;25(1):25-42.
14. Bravo G, Raiche M, Dubois MF, Hebert R. Assessing the impact of integrated delivery systems: practical advice from three experiments conducted in Quebec. Journal of Integrated Care 2008;16(4):9-18.
15. Etheridge F, Couturier Y, Trouve H, Saint-Jean O, Somme D. Is the PRISMA-France glass half-full or half-empty? The emergence and management of polarized views regarding an integrative change process. International Journal of Integrated Care [Serial online] 2009 Dec 16;9[cited 2012 June 1]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-100752.
16. Trouve H, Couturier Y, Etheridge F, Saint-Jean O, Somme D. The path dependency theory: analytical framework to study institutional integration. The case of France. International Journal of Integrated Care [Serial online] 2010 Jun 20;10[cited 2012 June 1]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-100886
17. Johri M, Beland F, Bergman H. International experiments in integrated care for the elderly: a synthesis of the evidence. International Journal of Geriatric Psychiatry 2003;18(3):222-35.
18. WHO. Integrated health services-what and why? Technical Brief No 1. Geneva: World Health Organisation; 2008.
19. MacAdam M, Networks CPR. Frameworks of integrated care for the elderly: a systematic review: Canadian Policy Research Networks. 2008.
20. Morin D, Tourigny A, Pelletier D, Robichaud L, Mathieu L, Vezina A, et al. Seniors' views on the use of electronic health records. Informatics in Primary Care 2005;13:125-33.
21. Davies S, Goodman C, Bunn F, Victor C, Dickinson A, Iliffe S, et al. A systematic review of integrated working between care homes and health care services. BMC Health Services Research 2011;11(320):doi: 10.1186/472-6963-11-320.
22. Hebert R, Carrier R, Bilodeau A. The Functional Autonomy Measurement System (SMAF): description and validation of an instrument for the measurement of handicaps. Age and Ageing 1988;17:293-302.
23. Dubuc N, Dubois M, Raiche M, Gueye N, Hebert R. Meeting the home-care needs of disabled older persons living in the community: does integrated services delivery make a difference? BMC Geriatrics 2011;11(67). doi:10.1186/1471-2318-11-67.
24. Petticrew M, Whitehead M, Macintyre SJ, Graham H, Egan M. Evidence for public health policy on inequalities: 1: the reality according to policymakers. Journal of Epidemiology and Community Health 2004;58(10):811.
25. Leutz WN. Five laws for integrating medical and social services: lessons from the United States and the United Kingdom. Milbank Quarterly 1999;77(1):77-110.
26. Hébert R, Raîche M, Dubois M-F, Gueye NDR, Dubuc N, Tousignant M, et al. Impact of PRISMA, a coordination-type integrated service delivery system for frail older people in Quebec (Canada): A quasi-experimental study. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 2010;65B(1):107-18.
27. Hébert R. PRISMA: a good example of transferring research evidence into public policy. International Journal of Integrated Care [Serial online] 2011 May 24;11. [cited 2013 Jan 26]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-101448.
28. Trouve H, Veil A, Hebert R, Somme D. The PRISMA-France study: is there a way to measure implementation of integration in different countries? In: Smigorski K, editor. Health Management Intech 2011. p. 315-336.
29. Somme D, Stampa M. Ten years of integrated care for the older in France. International Journal of Integrated Care [Serial online] 2011 Dec 14;11. [cited 2013 Jan 26]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-101683.
30. Pinsonnault E. Functional Autonomy measurement system: development of a social subscale. Archives of Gerontology and Geriatrics 2003;37(3):223-33.
31. Hébert R, Durand PJ, Dubuc N, Tourigny A. PRISMA: a new model of integrated service delivery for the frail older people in Canada. International Journal of Integrated Care [Serial online] 2003 Mar;18:3[cited 2013 Jan 26]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-100315.
32. Desrosiers J, Bravo G, Hebert R, Dubuc N. Reliability of the revised functional autonomy measurement system (SMAF) for epidemiological research. Age and Ageing 1995;24(5):402.
33. Hebert R, Bravo G, Korner-Bitensky N, Voyer L. Refusal and information bias associated with postal questionnaires and face-to-face interviews in very elderly subjects. Journal of Clinical Epidemiology 1996;49(3):373-81.
34. Hebert R, Bravo G, Korner-Bitensky N, Voyer L. Predictive validity of a postal questionnaire for screening community-dwelling elderly individuals at risk of functional decline. Age and Ageing 1996;25(2):159-67.
35. Hebert R, Bravo G, Preville M. Reliability, validity and reference values of the Zarit Burden Interview for assessing informal caregivers of community-dwelling older persons with dementia. Canadian Journal on Ageing 2000;19(4): 494-507.
36. Tousignant M, Hebert R, Dubuc N, Simoneau F, Dieleman L. Application of a case-mix classification based on the functional autonomy of the residents for funding long-term care facilities. Age and Ageing 2003;32:60-6.
37. Hébert RR, Veil AA. Monitoring the degree of implementation of an integrated delivery system. International Journal of Integrated Care [Serial online] 2004 Sep;20:4[cited 2013 Jan 26]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-100348.
38. Dubuc N, Hebert R, Desrosiers J, Buteau M, Trottier L. Disability-based classification system for older people in integrated long-term care services: The Iso-SMAF profiles. Archives of Gerontology and Geriatrics 2006;42(2):191-206.
39. Gagnon M, Hebert R, Dube M, Dubois MF. Development and validation of the Health Care Satisfaction Questionnaire (HCSQ) in elders. Journal of Nursing Management 2006;14(3):190-204.
40. Gagnon M, Hebert R, Dube M, Dubois M. Development and validation of an instrument measuring individual empowerment in relation to personal health care: the Health Care Empowerment Questionnaire (HCEQ). American Journal of Health Promotion 2006;20(6):429-35.
41. Dubois M, Raiche M, Hebert R, Gueye N. Assisted self-report of health-services use showed excellent reliability in a longitudinal study of older adults. Journal of Clinical Epidemiology 2007;60(10):1040-5.
42. Somme D, Hebert R, Bravo G, Blanchard F, Saint-Jean O. The individualized service plan as a clinical integration tool: qualitative analysis in the Quebec PRISMA experiment. International Journal of Integrated Care [Serial online] 2007 Dec;19:7[cited 2013 Jan 26]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-100457.
43. Kroger E, Tourigny A, Morin D, Cote L, Kergoat M-J, Lebel P, et al. Selecting process quality indicators for the integrated care of vulnerable older adults affected by cognitive impairment or dementia. BMC Health Services Research 2007;7(1):195.
44. Raiche M, Hebert R, Dubois M. PRISMA-7: A case-finding tool to identify older adults with moderate to severe disabilities. Archives of Gerontology and Geriatrics 2008;47(1):9-18.
45. Pinsonnault E, Dubuc N, Desrosiers J, Delli-Colli N, Hébert R. Validation study of a social functioning scale: The social-SMAF (social-Functional Autonomy Measurement System). Archives of Gerontology and Geriatrics 2009;48(1):40-4.
46. Somme D, Bonin L, Lebel P, Hébert R, Blanchard F. Development of an individualized service plan tool and rules for case management in Québec. Care Management Journals 2009;10(3):89-99.
47. Hébert R, Raîche M, Gueye NDR. Survey disability questionnaire does not generate valid accurate data compared to clinical assessment on an older population. Archives of Gerontology and Geriatrics 2012;54(2):e57-e62.
48. Hébert R, Brayne C, Spiegelhalter D. Incidence of functional decline and improvement in a community-dwelling, very elderly population. American Journal of Epidemiology 1997;145(10):935-44.
49. Hebert R, Dubuc N, Buteau M, Desrosiers J, Bravo G, Trottier L, et al. Resources and costs associated with diasbilities of elderly people living at home and in institutions. Canadian Journal on Aging 2001;20(1).
50. Tousignant M, Hebert R, Desrosiers J, Hollander MJ. Economic evaluation of a geriatric day hospital: cost-benefit analysis based on functional autonomy changes. Age and Ageing 2003;32:53-9.
51. Tourigny A, Durand PJ, Bonin L, Hebert R. Quasi-experimental study of the effectiveness of an integrated service delivery network for the frail elderly. Canadian Journal on Ageing 2004;23(3):231-46.
52. Milette L, Hebert R, Veil A. Early perceptions of family physicians regarding the introduction of integrated service delivery networks for older people. Canadian Family Physician 2005;51:1104-5.
53. Tousignant M, Dubuc N, Hébert R, Coulombe C. Home-care programmes for older adults with disabilities in Canada: How can we assess the adequacy of services provided compared with the needs of users? Health and Social Care in the Community 2007 Jan;15(1):1-7.
54. Hébert R, Veil A, Raîche M, Dubois MF, Dubuc N, Tousignant M. Evaluation of the implementation of PRISMA, a coordination-type integrated service delivery system for frail older people in Quebec. Journal of Integrated Care 2008;16(6):4-14.
55. Dubois M-F, Dubuc N, Raiche M, Caron CD, Hébert R, et al. Correlates of the perceived need for institutionalisation among older adults without cognitive impairment. Gerontology 2008;54(4):244-51.
56. Hebert R, Dubois MF, Raiche M, Dubuc N, The PRISMA-Estrie Group. The effectiveness of the PRISMA integrated service delivery network: Preliminary report on methods and baseline data. International Journal of Integrated Care [Serial online] 2008 Feb;14:8[cited 2013 Jan 26]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-100471.
57. Dubois M-F, Dubuc N, Caron CD, Raîche M, Hébert R. Is there agreement between Canadian older adults and their primary informal caregivers on behaviour towards institutionalisation? Health & Social Care in the Community 2009;17(6):610-8.
58. Raîche M, Hébert R, Dubois M-F, Gueye NDR, Dubuc N. Yearly transitions of disability profiles in older people living at home. Archives of Gerontology and Geriatrics 2011;55(2):399-405.
59. Lestage C, Dubuc N, Bravo G. Identifying characteristics of residential aged care facilities relevant to the placement process of seniors. Journal of the American Medical Directors Association 2008 Feb95-101.
60. Hebert R. Home care: from adequate funding to integration of services. Healthcare Papers 2009;10(1):58-64.
61. Hebert R. An urgent need to improve life conditions of seniors. The Journal of Nutrition, Health & Aging 2010;14(8):711-4.
62. Hebert R, Guilbault J, Desroisers J, Dubuc N. The Functional Autonomy Measurement System (SMAF): A clinical-based instrument for measuring disabilities and handicaps in older people. Geriatrics Today 2001;141-7.
63. Hebert R, Tourigny A, Raiche M, editors. Integration of services for disabled people: research leading to action. Quebec: Edisem; 2008.
64. Hébert R, Tourigny A, Gagnon M, PRISMA. Integrated service delivery to ensure persons' functional autonomy. Quebec: Edisem; 2005.
65. Zarit SH, Orr NK, Zarit JM. The hidden victims of Alzheimer's disease: Families under stress. New York: NYU Press; 1985.
66. Morycz RK. Caregiving strain and the desire to institutionalize family members with Alzheimer's disease. Research on Aging 1985;7(3):329.
67. Nutley SM, Davies H, Smith PC. What works?: Evidence-based policy and practice in public services. UK: The Policy Press; 2000.
68. Mays N, Pope C, Popay J. Systematically reviewing qualitative and quantitative evidence to inform management and policymaking in the health field. Journal of health services research & policy 2005;10(suppl1):6-20.
69. Hollander MJ, Prince MJ. Organizing healthcare delivery systems for persons with ongoing care needs and their families: a best practices framework. Healthcare Quarterly 2008;11(1).
70. Institute of Medicine (IOM). Health IT and Patient Safety: Building Safer Systems for Better Care. Washington, DC: National Academies Press.
71. Ash JS, Berg M, Coiera E. Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. Journal of the American Medical Informatics Association 2004;11(2):104-12.