International Journal of Integrated Care (May 2020)
Impact Assessment of an Innovative Integrated Care Model for Older Complex Patients with Multimorbidity: The CareWell Project
- Maider Mateo-Abad,
- Ane Fullaondo,
- Marisa Merino,
- Stefano Gris,
- Francesco Marchet,
- Francesca Avolio,
- Elisabetta Graps,
- Mario Ravic,
- Mario Kovac,
- Vanesa Benkovic,
- Ranko Stevanovic,
- Antoni Zwiefka,
- Daniel Davies,
- Silvia Mancin,
- Antonella Forestiero,
- Panos Stafylas,
- Mayte Hurtado,
- Marco d´Angelantonio,
- Signe Daugbjerg,
- Claus Duedal Pedersen,
- Reinhard Hammerschmidt,
- Veli Stroetmann,
- Lierni Azkargorta,
- Anna Giné,
- Dolores Verdoy,
- Myriam Soto-Gordoa,
- Joana Mora,
- Javier Mar,
- Itziar Vergara,
- Esteban de Manuel Keenoy,
- on behalf of the CareWell project group
Affiliations
- Maider Mateo-Abad
- Kronikgune Institute for Health Services Research, Barakaldo, Basque Country; Health Services Research on Chronic Patients Network (REDISSEC), Barakaldo, Basque Country
- Ane Fullaondo
- Kronikgune Institute for Health Services Research, Barakaldo, Basque Country
- Marisa Merino
- Osakidetza Basque Health Sevice, Tolosaldea Integrated Health Care Organization, Tolosa, Basque Country; Biodonostia Health Research Institute, Donostia, Basque Country
- Stefano Gris
- Azienda ULSS 1 Dolomiti, Local Health Authority, Feltre, Belluno
- Francesco Marchet
- Azienda ULSS 1 Dolomiti, Local Health Authority, Feltre, Belluno
- Francesca Avolio
- Agenzia Regionale per la salute e Sociale – Regione Puglia, Bari, Puglia
- Elisabetta Graps
- Health Technology Assessment – UNIT, Regional Strategic Agency for Health and Social Affair (AReSS), Bari
- Mario Ravic
- Ericsson Nikola Tesla d.d., Zagreb
- Mario Kovac
- Dept. of Control and Computer Engineering, Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb
- Vanesa Benkovic
- Croatian Society for Pharmacoeconomics and Health Economics, Zagreb
- Ranko Stevanovic
- Croatian Society for Pharmacoeconomics and Health Economics, Zagreb
- Antoni Zwiefka
- Department of Health, LSV Marshal Office
- Daniel Davies
- Powys Teaching Health Board, Bronllys Hospital, Bronllys, Powys
- Silvia Mancin
- Arsenàl.IT, Veneto’s Research Centre for eHealth Innovation, Treviso
- Antonella Forestiero
- Arsenàl.IT, Veneto’s Research Centre for eHealth Innovation, Treviso
- Panos Stafylas
- HealThink, Thessaloniki
- Mayte Hurtado
- Health Information Management S.A. – HIM S.A., MAST European Economic Interest Group, Brussels
- Marco d´Angelantonio
- Health Information Management S.A. – HIM S.A., MAST European Economic Interest Group, Brussels
- Signe Daugbjerg
- Centre for Innovative Medical Technology, Odense University Hospital, Odense
- Claus Duedal Pedersen
- Centre for Innovative Medical Technology, Odense University Hospital, Odense
- Reinhard Hammerschmidt
- Empirica Communication and Technology Research, Bonn
- Veli Stroetmann
- Empirica Communication and Technology Research, Bonn
- Lierni Azkargorta
- Osakidetza Basque Health Sevice, Tolosaldea Integrated Health Care Organization, Tolosa, Basque Country
- Anna Giné
- Kronikgune Institute for Health Services Research, Barakaldo, Basque Country
- Dolores Verdoy
- Kronikgune Institute for Health Services Research, Barakaldo, Basque Country
- Myriam Soto-Gordoa
- Kronikgune Institute for Health Services Research, Barakaldo, Basque Country; Biodonostia Health Research Institute, Donostia, Basque Country
- Joana Mora
- Kronikgune Institute for Health Services Research, Barakaldo, Basque Country
- Javier Mar
- Health Services Research on Chronic Patients Network (REDISSEC), Barakaldo, Basque Country; Biodonostia Health Research Institute, Donostia, Basque Country; Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Mondragon, Basque Country
- Itziar Vergara
- Kronikgune Institute for Health Services Research, Barakaldo, Basque Country; Health Services Research on Chronic Patients Network (REDISSEC), Barakaldo, Basque Country; Biodonostia Health Research Institute, Primary Care Group, Donostia, Basque Country
- Esteban de Manuel Keenoy
- Kronikgune Institute for Health Services Research, Barakaldo, Basque Country
- on behalf of the CareWell project group
- DOI
- https://doi.org/10.5334/ijic.4711
- Journal volume & issue
-
Vol. 20,
no. 2
Abstract
Objectives: To evaluate the impact in terms of use of health services, clinical outcomes, functional status, and patient´s satisfaction of an integrated care program, the CareWell program, for complex patients with multimorbidity, supported by information and communication technology platforms in six European regions. Data Sources: Primary data were used and the follow-up period ranged between 8 and 12 months. Study design: A quasi-experimental study, targeting chronic patients aged 65 or older, with 2 or more conditions – one of them necessarily being diabetes, congestive heart failure or congestive obstructive pulmonary disease. The intervention group received the integrated care program and the control group received usual care. Generalized mixed regression models were used. Data collection: Data were obtained from individual interviews and electronic clinical records. Principal Findings: Overall, 856 patients were recruited (475 intervention and 381 control). In the intervention group, the number of visits to emergency rooms was significantly lower, and the number of visits to the general practitioners and primary care nurses was higher than in the control group. Conclusion: The CareWell program resulted in improvements in the use of health services, strengthening the role of PC as the cornerstone of care provision for complex patients with multimorbidity.
Keywords
