Innovative models of healthcare delivery: an umbrella review of reviews
Frances Rapport,
Jeffrey Braithwaite,
Yvonne Zurynski,
Peter D Hibbert,
Kate Churruca,
Louise A Ellis,
Chiara Pomare,
Robyn Clay-Williams,
Stephanie Best,
Janet C Long,
Gaston Arnolda,
Bróna Nic Giolla Easpaig,
Zeyad Mahmoud,
Mitchell N Sarkies,
Hoa Mi Nguyen,
Karen Hutchinson,
Gilbert Thomas Knaggs,
Katherine Maka,
Elizabeth E Austin,
Diana Fajardo Pulido,
Sarah Hatem,
Natalie Roberts,
Emilie Francis Auton,
Genevieve Dammery,
Isabelle Meulenbroeks,
Ann Carrigan,
Mai-Tran Nguyen
Affiliations
Frances Rapport
Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
Jeffrey Braithwaite
5 Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Yvonne Zurynski
professor
Peter D Hibbert
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Kate Churruca
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Louise A Ellis
5 Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Chiara Pomare
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Robyn Clay-Williams
1 Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
Stephanie Best
Australian Genomics Health Alliance, Parkville, Victoria, Australia
Janet C Long
1 Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Gaston Arnolda
1 Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
Bróna Nic Giolla Easpaig
1 Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
Zeyad Mahmoud
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Mitchell N Sarkies
Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
Hoa Mi Nguyen
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Karen Hutchinson
Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
Gilbert Thomas Knaggs
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Katherine Maka
2 Western Sydney Local Health District, Wentworthville, New South Wales, Australia
Elizabeth E Austin
1 Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
Diana Fajardo Pulido
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Sarah Hatem
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Natalie Roberts
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Emilie Francis Auton
1 Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Genevieve Dammery
research assistant
Isabelle Meulenbroeks
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Ann Carrigan
research fellow
Mai-Tran Nguyen
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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.
