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Integrated Care Approaches Used for Transitions from Hospital to Community Care: A Scoping Review

Published online by Cambridge University Press:  10 April 2018

Cara L. Brown Open the ORCID record for Cara L. Brown [Opens in a new window]  and
Verena Menec
Cara L. Brown*
Affiliation:
Department of Community Health Sciences, Faculty of Health Sciences, University of Manitoba
Verena Menec
Affiliation:
Department of Community Health Sciences, Faculty of Health Sciences, University of Manitoba
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Cara L. Brown, M.Sc. Department of Community Health Sciences Max Rady College of Medicine Faculty of Health Sciences University of Manitoba R106, 771 McDermot Ave. Winnipeg, MB R3E 0T6 <[email protected]>
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Abstract

Integrated care is a promising approach for improving care transitions for older adults, but this concept is inconsistently defined and applied. This scoping review describes the size and nature of literature on integrated care initiatives for transitions from hospital to community care for older adults (aged 65 and older) and how this literature conceptualizes integrated care. A systematic search of literature from the past 10 years yielded 899 documents that were screened for inclusion by two reviewers. Of the 48 included documents, there were 26 journal articles and 22 grey literature documents. Analysis included descriptive statistics and a content analysis approach to summarize features of the integrated care initiatives. Results suggest that clinical and service delivery integration is being targeted rather than integration of funding, administration, and/or organization. To promote international comparison of integrated care initiatives aiming to improve care transitions, detailed descriptions of organizational context are also needed.

Résumé

Les soins intégrés constituent une approche prometteuse pour améliorer les transitions entre les soins pour les personnes âgées, mais il n’existe pas de consensus concernant ce concept ou ses applications. Cet examen de la portée décrit l’ampleur et le contenu des publications sur les initiatives de soins intégrés visant les transitions entre les soins hospitaliers et les soins en milieu communautaire pour les aînés (âgés de 65 ans ou plus), et la conceptualisation des soins intégrés dans ces écrits. Une recherche systématique dans la littérature des 10 dernières années a permis d’identifier 899 documents qui ont été examinés par deux évaluateurs. Des 48 documents sélectionnés, 26 étaient des articles de revues scientifiques et 22 des articles de la littérature grise.

Les analyses réalisées incluent des statistiques descriptives et une analyse de contenu qui résume les caractéristiques des initiatives de soins intégrés. Les résultats suggèrent que l’intégration de la prestation des soins et services est principalement visée par ces travaux, plutôt que l’intégration du financement, de l’administration ou de l’organisation des soins. Afin de permettre des comparaisons sur le plan international des initiatives de soins intégrés visant l’amélioration des transitions entre les soins, une description détaillée des contextes organisationnels serait aussi nécessaire.

Keywords

agingintegrated carecare transitionscare coordinationhospital carecommunity-based carevieillissementsoins intégréstransitions entre les soinscoordination des soinssoins hospitalierssoins en milieu communautaire
Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 37 , Issue 2 , June 2018 , pp. 145 - 170
Copyright
Copyright © Canadian Association on Gerontology 2018 

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Footnotes

*

Janice Linton, University of Manitoba Health Sciences librarian, provided invaluable advice regarding the systematic search strategy for this work. Thank you to the Centre on Aging at the University of Manitoba, and the Canadian Occupational Therapy Foundation for scholarship support of Cara Brown’s doctoral studies. Brown’s doctoral studies are also supported in part by a Health Research Graduate Studentship from Research Manitoba.

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