TY - JOUR
T1 - Health Care Coordination Theoretical Frameworks
T2 - a Systematic Scoping Review to Increase Their Understanding and Use in Practice
AU - Peterson, Kim
AU - Anderson, Johanna
AU - Bourne, Donald
AU - Charns, Martin P.
AU - Gorin, Sherri Sheinfeld
AU - Hynes, Denise M.
AU - McDonald, Kathryn M.
AU - Singer, Sara J.
AU - Yano, Elizabeth M.
N1 - Funding Information:
1Department of Veterans Affairs, VA Portland Health Care System, Evidence-based Synthesis Program (ESP) Coordinating Center, Portland, OR, USA; 2VA HSR&D Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA; 3Boston University School of Public Health, Boston, MA, USA; 4New York Physicians against Cancer (NYPAC), New York, NY, USA; 5The University of Michigan Medical School, Ann Arbor, MI, USA; 6Department of Veterans Affairs, VA Portland Health Care System, Portland, OR, USA; 7Oregon State University, Corvallis, OR, USA; 8Stanford University School of Medicine, Stanford, CA, USA; 9Stanford University Graduate School of Business, Stanford, CA, USA; 10VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Boston, MA, USA; 11Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
Funding Information:
Funding This material is based upon work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative (QUERI), Evidence-Based Synthesis Program (ESP). Dr. Yano’s time was supported by a VA HSR&D Senior Research Career Scientist Award (project no. RCS 05-195).
Publisher Copyright:
© 2019, Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply).
PY - 2019/5/15
Y1 - 2019/5/15
N2 - 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.
AB - 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.
KW - care coordination
KW - integrated care
KW - theoretical framework
KW - theoretical model
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U2 - 10.1007/s11606-019-04966-z
DO - 10.1007/s11606-019-04966-z
M3 - Review article
C2 - 31098976
AN - SCOPUS:85066043856
SN - 0884-8734
VL - 34
SP - 90
EP - 98
JO - Journal of general internal medicine
JF - Journal of general internal medicine
ER -