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Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts' perspective
Karolinska Institutet and Stockholm University, Solna.
Karolinska Institutet, Huddinge; Karolinska University Hospital, Stockholm; Stockholms Sjukhem, Stockholm.
Karolinska Institutet and Stockholm University, Solna; Karolinska Institutet, Solna.
Karolinska Institutet and Stockholm University, Solna.
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2024 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 295, no 6, p. 804-824Article, review/survey (Refereed) Published
Abstract [en]

Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers' scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field.

Place, publisher, year, edition, pages
2024. Vol. 295, no 6, p. 804-824
Keywords [en]
Sweden, integrated care, older people, person‐centered care
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:du-48444DOI: 10.1111/joim.13784ISI: 001208107500001PubMedID: 38664991Scopus ID: 2-s2.0-85191252820OAI: oai:DiVA.org:du-48444DiVA, id: diva2:1855389
Available from: 2024-04-30 Created: 2024-04-30 Last updated: 2024-05-21Bibliographically approved

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Marmstål Hammar, Lena

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CiteExportLink to record
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