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. 2025 Sep 18:5:1655472.
doi: 10.3389/frhs.2025.1655472. eCollection 2025.

Measuring person-centered integrated care for people living with mild to moderate chronic kidney disease and multimorbidity: a cross-sectional survey

Taylor Hecker  1 , Sabrina Jassemi  1 , Liza van Vliet  2 , Nancy Verdin  3 , Nazret Russon  3 , Meghan J Elliott  1 , Brenda R Hemmelgarn  4 , Maria J Santana  1 , Kimberly Manalili  5 , Kerry McBrien  1   5 , Aminu K Bello  4 , Amity Quinn  1 , Pim Valentijn  2   6 , Maoliosa Donald  1
Affiliations

Measuring person-centered integrated care for people living with mild to moderate chronic kidney disease and multimorbidity: a cross-sectional survey

Taylor Hecker et al. Front Health Serv. .

Abstract

Introduction: Person-centered integrated care (PC-IC) has been shown to improve health outcomes for individuals with chronic conditions. However, there is limited evidence measuring PC-IC delivery to people with mild to moderate chronic kidney disease and co-morbidities. We aimed to assess PC-IC delivery for this population in Alberta, Canada.

Methods: We conducted a survey (May-December 2023) using the Rainbow Model of Integrated Care Measurement Tool via weblink or telephone to quantify PC-IC using a 5-point Likert agreement scale. Patients with chronic kidney disease (non-dialysis, non-transplant) and co-morbidities, caregivers, and health care providers in Alberta were invited to participate. Participants were recruited through various methods, including in-clinic posters and web-based posts. We assessed responses using descriptive and non-parametric analyses (e.g., Mann-Whitney U-test).

Results: Ninety-seven eligible individuals completed the survey; 24 patients, 12 caregivers, and 61 health care providers. Caregivers rated PC-IC significantly lower than patients (overall score: 3.36/5 and 3.91/5, respectively, p < 0.05) and health care providers rated PC-IC moderately (3.56/5). The lowest scored domain was care coordination amongst patients and caregivers (3.43/5 and 3/5, respectively, p < 0.05) and regional health care laws/regulations amongst health care providers (2.94/5).

Conclusion: Survey respondents recognized that the overall delivery of PC-IC is not optimal and identified key areas to address including improving care coordination (e.g., communication between providers) and tackling regional health care laws/regulations (e.g., funding models). Our study highlights the need for further exploration regarding why PC-IC is perceived as suboptimal, particularly among subgroups, and how it can be improved.

Keywords: chronic kidney disease; multidisciplinary care; multimorbidity; patient-oriented research; person-centered integrated care.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
RMIC framework. The Rainbow Model for Integrated Care by P.P. Valentijn, 2015. Copyright 2017 by Essenburgh Group, Harderwijk, The Netherlands. Reproduced with permission (15).
Figure 2
Figure 2
Overall RMIC-MT integrated care scores for all groups. * Indicates a statistically significant difference (p < 0.05).
Figure 3
Figure 3
Patient (n = 24) & caregiver (n = 12) RMIC-MT domain scores. * Indicates a statistically significant difference (p < 0.05).
Figure 4
Figure 4
Health care provider (n = 61) RMIC-MT domain scores.
See this image and copyright information in PMC

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