Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts' perspectiveInternational Foundation for Integrated Care (IFIC), Glasgow, Scotland, UK, GB; University of the West of Scotland, Glasgow, Scotland, UK, GB.
Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, The University of Sydney, Sydney, Australia, AU.
Karolinska Institutet and Stockholm University, Solna; Stockholm Gerontology Research Center, Stockholm.
Karolinska Institutet and Stockholm University, Solna; Karolinska Institutet, Solna; University of Duisburg-Essen, Duisburg, Germany, DE.
Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care - GPCC, Gothenburg.
Lund University, Lund.
Karolinska University Hospital, Stockholm; Karolinska Institutet, Huddinge.
Karolinska Institutet and Stockholm University, Solna; Karolinska Institutet, Solna; University of Duisburg-Essen, Duisburg, Germany, DE.
Mälardalen University, Eskilstuna.
Stockholm Gerontology Research Center, Stockholm.
Norrtälje Hospital, Vårdbolaget Tiohundra, Stockholm.
Karolinska Institutet and Stockholm University, Solna; Swedish Institute for Social Research (SOFI), Stockholm University, Stockholm.
Karolinska Institutet, Huddinge.
Myndigheten för vård- och omsorgsanalys, Stockholm.
Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care - GPCC, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
Linnaeus University, Växjö.
Örebro University, Örebro.
Sahlgrenska Academy, University of Gothenburg, Gothenburg.
Jönköping University, Jönköping.
Karolinska Institutet and Stockholm University, Solna; Stockholm Gerontology Research Center, Stockholm.
Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care - GPCC, Gothenburg; Chalmers University of Technology, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
Karolinska Institutet and Stockholm University, Solna; Karolinska Institutet, Solna.
Karolinska Institutet and Stockholm University, Solna; Stockholm Gerontology Research Center, Stockholm.
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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 and Social Medicine
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
2024-04-302024-04-302025-02-20Bibliographically approved