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. 2023 Feb 23;13(2):e066270.
doi: 10.1136/bmjopen-2022-066270.

Innovative models of healthcare delivery: an umbrella review of reviews

Natalie Roberts  1 , Ann Carrigan  1 , Robyn Clay-Williams  2 , Peter D Hibbert  1   3 , Zeyad Mahmoud  1   4 , Chiara Pomare  1 , Diana Fajardo Pulido  1 , Isabelle Meulenbroeks  1 , Gilbert Thomas Knaggs  1 , Elizabeth E Austin  1 , Kate Churruca  1 , Louise A Ellis  1 , Janet C Long  1 , Karen Hutchinson  1 , Stephanie Best  1   5 , Brona Nic Giolla Easpaig  1 , Mitchell N Sarkies  1 , Emilie Francis Auton  1 , Sarah Hatem  1 , Genevieve Dammery  1 , Mai-Tran Nguyen  1 , Hoa Mi Nguyen  1 , Gaston Arnolda  1 , Frances Rapport  1 , Yvonne Zurynski  1 , Katherine Maka  6 , Jeffrey Braithwaite  1
Affiliations

Innovative models of healthcare delivery: an umbrella review of reviews

Natalie Roberts et al. BMJ Open. .

Abstract

Objective: To undertake a synthesis of evidence-based research for seven innovative models of care to inform the development of new hospitals.

Design: Umbrella review.

Setting: Interventions delivered inside and outside of acute care settings.

Participants: Children and adults with one or more identified acute or chronic health conditions.

Data sources: PsycINFO, Ovid MEDLINE and CINAHL.

Primary and secondary outcome measures: Clinical indicators and mortality, healthcare utilisation, quality of life, self-management and self-care and patient knowledge.

Results: A total of 66 reviews were included, synthesising evidence from 1272 primary studies across the 7 models of care. Virtual care was the most common model studied, addressed by 47 (73%) of the reviews. Common outcomes evaluated across reviews were clinical indicators and mortality, healthcare utilisation, self-care and self-management, patient knowledge, quality of life and cost-effectiveness. The findings indicate that the innovative models of healthcare we identified in this review may be effective in managing patients with a range of acute and chronic conditions. Most of the included reviews reported evidence of comparable or improved care.

Conclusions: A consideration of local infrastructure and individual patient characteristics, such as health literacy, may be critical in determining the suitability of models of care for patients and their implementation in local health systems.

Trial registration number: 10.17605/OSF.IO/PS6ZU.

Keywords: dialysis; heart failure; public health; telemedicine.

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Conflict of interest statement

Competing interests: There are no competing interests to declare between the authors and Health Infrastructure. The project was commissioned by Health Infrastructure NSW and Western Sydney LHD (WSLHD). KM works for WSLHD; however, this did not inform the evaluation of evidence or conclusions of the review.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram for initial and updated search. Black text: original search; blue text: updated search. *Some reports were excluded for multiple reasons.
Figure 2
Figure 2
Relationships among models across reviews.
See this image and copyright information in PMC

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References

    1. Department of Health . Systemic national challenges in health care: australian government. 2013. Available: https://www1.health.gov.au/internet/publications/publishing.nsf/Content/...
    1. Amalberti R, Nicklin W, Braithwaite J. Preparing National health systems to cope with the impending tsunami of ageing and its associated complexities: towards more sustainable health care. Int J Qual Health Care 2016;28:412–4. 10.1093/intqhc/mzw021 - DOI - PubMed
    1. Conley J, O’Brien CW, Leff BA, et al. . Alternative strategies to inpatient hospitalization for acute medical conditions: a systematic review. JAMA Intern Med 2016;176:1693–702. 10.1001/jamainternmed.2016.5974 - DOI - PubMed
    1. The Australian Digital Health Agency . Framework for action: how australia will deliver the benefits of digitally enabled health and care. 2020. Available: https://conversation.digitalhealth.gov.au/sites/default/files/framework_...
    1. The Mckell Institute . Positive disruption: healthcare, ageing & participation in the age of technology. 2015. Available: https://mckellinstitute.org.au/app/uploads/The-McKell-Institute-Positive...

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