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. 2019 May;34(Suppl 1):90-98.
doi: 10.1007/s11606-019-04966-z.

Health Care Coordination Theoretical Frameworks: a Systematic Scoping Review to Increase Their Understanding and Use in Practice

Kim Peterson  1 , Johanna Anderson  2 , Donald Bourne  2 , Martin P Charns  3   4 , Sherri Sheinfeld Gorin  5   6 , Denise M Hynes  7   8 , Kathryn M McDonald  9 , Sara J Singer  9   10 , Elizabeth M Yano  11   12
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Health Care Coordination Theoretical Frameworks: a Systematic Scoping Review to Increase Their Understanding and Use in Practice

Kim Peterson et al. J Gen Intern Med. 2019 May.

Abstract

Background: Care coordination is crucial to avoid potential risks of care fragmentation in people with complex care needs. While there are many empirical and conceptual approaches to measuring and improving care coordination, use of theory is limited by its complexity and the wide variability of available frameworks. We systematically identified and categorized existing care coordination theoretical frameworks in new ways to make the theory-to-practice link more accessible.

Methods: To identify relevant frameworks, we searched MEDLINE®, Cochrane, CINAHL, PsycINFO, and SocINDEX from 2010 to May 2018, and various other nonbibliographic sources. We summarized framework characteristics and organized them using categories from the Sustainable intEgrated chronic care modeLs for multi-morbidity: delivery, FInancing, and performancE (SELFIE) framework. Based on expert input, we then categorized available frameworks on consideration of whether they addressed contextual factors, what locus they addressed, and their design elements. We used predefined criteria for study selection and data abstraction.

Results: Among 4389 citations, we identified 37 widely diverse frameworks, including 16 recent frameworks unidentified by previous reviews. Few led to development of measures (39%) or initiatives (6%). We identified 5 that are most relevant to primary care. The 2018 framework by Weaver et al., describing relationships between a wide range of primary care-specific domains, may be the most useful to those investigating the effectiveness of primary care coordination approaches. We also identified 3 frameworks focused on locus and design features of implementation that could prove especially useful to those responsible for implementing care coordination.

Discussion: This review identified the most comprehensive frameworks and their main emphases for several general practice-relevant applications. Greater application of these frameworks in the design and evaluation of coordination approaches may increase their consistent implementation and measurement. Future research should emphasize implementation-focused frameworks that better identify factors and mechanisms through which an initiative achieves impact.

Keywords: care coordination; integrated care; theoretical framework; theoretical model.

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Conflict of interest statement

KP, JA, DB, DH, SSG, KM, SS, and BY declare no conflicts of interest. MC wishes to disclose a VA HSR&D IIR 12-346 Patient Experienced Integrated Care for Veterans with Multiple Chronic Conditions grant that ended 9/30/17 as a potential conflict of interest.

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References

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