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. 2021 Feb 9;21(1):4.
doi: 10.5334/ijic.5508.

Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review

Sara Murtagh  1 , Geoff McCombe  1 , John Broughan  1 , Áine Carroll  1 , Mary Casey  2 , Áine Harrold  1 , Thomas Dennehy  1 , Ronan Fawsitt  1   3 , Walter Cullen  1
Affiliations

Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review

Sara Murtagh et al. Int J Integr Care. .

Abstract

Background: In Ireland, as in many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of chronic disease. Integrated care is an approach to healthcare systems delivery that aims to minimise fragmentation of patient services and improve care continuity. To this end, how best to integrate primary and secondary care is a challenge. This paper aims to undertake a scoping review of empirical work on the integration of primary and secondary care in relation to chronic disease management.

Methods: A search was conducted of 'PubMed', 'Cochrane Library' and 'Google Scholar' for papers published between 2009-2019 using Arksey and O'Malley's framework for conducing scoping reviews.

Results: Twenty-two studies were included. These reported research from a wide range of healthcare systems (most commonly UK, Australia, the Netherlands), adopted a range of methodologies (most commonly randomised/non-randomised controlled trials, case studies, qualitative studies) and among patients with a range of chronic conditions (most commonly diabetes, COPD, Parkinson's disease). No studies reported on interventions to address the needs of whole populations. Interventions to enhance integration included multidisciplinary teams, education of healthcare professionals, and e-health interventions. Among the effectiveness measures reported were improved disease specific outcomes, and cost effectiveness.

Conclusion: With healthcare systems increasingly recognising that integrated approaches to patient care can enhance chronic disease management, considerable literature now informs how this can be done. However, most of the research published has focussed on specific diseases and their clinical outcomes. Future research should focus on how such approaches may improve health outcomes for populations as a whole.

Keywords: chronic disease; integrated care; primary care; scoping review; secondary care.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Flowchart illustrating the paper selection process.
See this image and copyright information in PMC

References

    1. Jennings SM. Preventing chronic disease: defining the problem.
    1. Gröne O, Garcia-Barbero M. Integrated care: a position paper of the WHO European Office for Integrated Health Care Services. International journal of integrated care, 2001; 1 DOI: 10.5334/ijic.28 - DOI - PMC - PubMed
    1. Kodner DL, Spreeuwenberg C. Integrated care: meaning, logic, applications, and implications–a discussion paper. International journal of integrated care, 2002; 2 DOI: 10.5334/ijic.67 - DOI - PMC - PubMed
    1. Armitage GD, Suter E, Oelke ND, Adair CE. Health systems integration: state of the evidence. International journal of integrated care, 2009; 9 DOI: 10.5334/ijic.316 - DOI - PMC - PubMed
    1. Valentijn PP, Schepman SM, Opheij W, Bruijnzeels MA. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. International journal of integrated care, 2013; 13 DOI: 10.5334/ijic.886 - DOI - PMC - PubMed

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