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

doi:10.1136/bmjopen-2022-066270

BMJ Open (Feb 2023)

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, Sydney, New South Wales, Australia
Jeffrey Braithwaite: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Yvonne Zurynski: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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: 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: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Stephanie Best: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Janet C Long: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Gaston Arnolda: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Bróna Nic Giolla Easpaig: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Zeyad Mahmoud: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Mitchell N Sarkies: Australian Institute of Health Innovation, Macquarie University, 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, Sydney, New South Wales, Australia
Gilbert Thomas Knaggs: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Katherine Maka: Western Sydney Local Health District, Wentworthville, New South Wales, Australia
Elizabeth E Austin: Australian Institute of Health Innovation, 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: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Genevieve Dammery: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Isabelle Meulenbroeks: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Ann Carrigan: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
Mai-Tran Nguyen: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia

DOI: https://doi.org/10.1136/bmjopen-2022-066270
Journal volume & issue: Vol. 13, no. 2

Abstract

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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.

Published in BMJ Open

ISSN: 2044-6055 (Online)
Publisher: BMJ Publishing Group
Country of publisher: United Kingdom
LCC subjects: Medicine
Website: https://bmjopen.bmj.com

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