Elements of integrated care approaches for older people: a review of reviews.
Elements of integrated care approaches for older people: a review of reviews.
复制标题
DOI：
10.1136/bmjopen-2017-021194
复制
发表时间：
2018-04-07
期刊：
影响因子：
2.9
通讯作者：
Araujo de Carvalho I
中科院分区：
文献类型：
--
作者：
Briggs AM;Valentijn PP;Thiyagarajan JA;Araujo de Carvalho I
世界卫生组织（世卫组织）最近提出了老年人综合护理办法，以指导卫生系统和服务更好地支持老年人的功能。在老年人保健和社会护理提供系统中使用的综合护理方法的关键要素方面仍然存在知识差距。本综述的目的是识别和描述文献中报道的老年人综合护理模式的关键要素。使用系统检索方法对综述进行综述。2017年6月在MEDLINE和科克伦数据库中进行了系统检索。纳入了针对≥60岁人群的临床（微观）、组织/服务（中观）或卫生系统（宏观）层面的护理整合干预措施的审查。排除了2015年之前发表的非Cochrane综述。使用多个系统性综述评估（AMSTAR）1工具评估综述的质量。纳入了15篇综述（11篇系统性综述，其中6篇为科克伦综述），代表219项主要研究。3篇综述（20%）仅包括随机对照试验（RCT），而10篇综述（65%）同时包括RCT和非RCT。主要研究数量最多的地区是北美（n=89，47.6%），其次是欧洲（n=60，32.1%）和大洋洲（n=31，16.6%）。11篇（73%）综述集中于临床“微观”和组织“中观”护理整合策略。综合护理模式中最常见的要素是多学科团队、综合评估和病例管理。护士、理疗师、全科医生和社会工作者是最常报告的服务提供者。方法质量是可变的（AMSTAR评分：1-11）。7篇（47%）评论被评为高质量（AMSTAR评分≥8）。老年人综合护理要素的证据特别侧重于微观临床护理整合过程，而关于中观组织和宏观系统级护理整合战略的信息相对缺乏。
The World Health Organization (WHO) recently proposed an Integrated Care for Older People approach to guide health systems and services in better supporting functional ability of older people. A knowledge gap remains in the key elements of integrated care approaches used in health and social care delivery systems for older populations. The objective of this review was to identify and describe the key elements of integrated care models for elderly people reported in the literature. Review of reviews using a systematic search method. A systematic search was performed in MEDLINE and the Cochrane database in June 2017. Reviews of interventions aimed at care integration at the clinical (micro), organisational/service (meso) or health system (macro) levels for people aged ≥60 years were included. Non-Cochrane reviews published before 2015 were excluded. Reviews were assessed for quality using the Assessment of Multiple Systematic Reviews (AMSTAR) 1 tool. Fifteen reviews (11 systematic reviews, of which six were Cochrane reviews) were included, representing 219 primary studies. Three reviews (20%) included only randomised controlled trials (RCT), while 10 reviews (65%) included both RCTs and non-RCTs. The region where the largest number of primary studies originated was North America (n=89, 47.6%), followed by Europe (n=60, 32.1%) and Oceania (n=31, 16.6%). Eleven (73%) reviews focused on clinical ‘micro’ and organisational ‘meso’ care integration strategies. The most commonly reported elements of integrated care models were multidisciplinary teams, comprehensive assessment and case management. Nurses, physiotherapists, general practitioners and social workers were the most commonly reported service providers. Methodological quality was variable (AMSTAR scores: 1–11). Seven (47%) reviews were scored as high quality (AMSTAR score ≥8). Evidence of elements of integrated care for older people focuses particularly on micro clinical care integration processes, while there is a relative lack of information regarding the meso organisational and macro system-level care integration strategies.
登录
查看更多内容
影响因子：
11.1
作者：
Araujo de Carvalho I;Epping-Jordan J;Pot AM;Kelley E;Toro N;Thiyagarajan JA;Beard JR
通讯作者：
Beard JR
影响因子：
2.4
作者：
Breton M;Gray CS;Sheridan N;Shaw J;Parsons J;Wankah P;Kenealy T;Baker R;Belzile L;Couturier Y;Denis JL;Wodchis WP
通讯作者：
Wodchis WP
影响因子：
3.4
作者：
Drewes, Hanneke W.;Steuten, Lotte M. G.;Vrijhoef, Hubertus J. M.
通讯作者：
Vrijhoef, Hubertus J. M.
影响因子：
1.3
作者：
Angus, Lisa;Valentijn, Pim P.
通讯作者：
Valentijn, Pim P.
影响因子：
105.7
作者：
Baztan, Juan J.;Suarez-Garcia, Francisco M.;Rodriguez-Artalejo, Fernando
通讯作者：
Rodriguez-Artalejo, Fernando