Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts’ perspective
Artikel i vetenskaplig tidskrift, 2024
Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers’ scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field.
person-centered care
older people
Sweden
integrated care
Författare
Mariam Kirvalidze
Karolinska Institutet
Anne Marie Boström
Stockholms Sjukhem
Karolinska universitetssjukhuset
Karolinska Institutet
Ann Liljas
Karolinska Institutet
Megan Doheny
Karolinska Institutet
Anne Hendry
International Foundation for Integrated Care ((IFIC))
University of the West of Scotland
Brendan McCormack
The University of Sydney
Laura Fratiglioni
Karolinska Institutet
Stiftelsen Stockholms Läns Äldrecentrum
Sulin Ali
Universität Duisburg-Essen
Karolinska Institutet
Zahra Ebrahimi
Göteborgs universitet
Sölve Elmståhl
Lunds universitet
Maria Eriksdotter
Karolinska Institutet
Karolinska universitetssjukhuset
Pascal Gläske
Karolinska Institutet
Universität Duisburg-Essen
Lena Karin Gustafsson
Mälardalens universitet
Åsa Hedberg Rundgren
Stiftelsen Stockholms Läns Äldrecentrum
Helena Hvitfeldt
Norrtälje Sjukhus
Carin Lennartsson
Karolinska Institutet
Stockholms universitet
Lena Marmstål Hammar
Mälardalens universitet
Högskolan i Dalarna
Gunnar H. Nilsson
Karolinska Institutet
Peter Nilsson
Myndigheten för vård- och omsorgsanalys
Joakim Öhlén
Göteborgs universitet
Sahlgrenska universitetssjukhuset
Anna Sandgren
Linnéuniversitetet
Annika Söderman
Örebro universitet
Karl Swedberg
Göteborgs universitet
Nicoline Vackerberg
Tekniska högskolan i Jönköping
Davide Liborio Vetrano
Stiftelsen Stockholms Läns Äldrecentrum
Karolinska Institutet
Helle Wijk
Sahlgrenska universitetssjukhuset
Göteborgs universitet
Chalmers, Arkitektur och samhällsbyggnadsteknik, Byggnadsdesign
Janne Agerholm
Karolinska Institutet
Amaia Calderón-Larrañaga
Stiftelsen Stockholms Läns Äldrecentrum
Karolinska Institutet
Journal of Internal Medicine
0954-6820 (ISSN) 1365-2796 (eISSN)
Vol. 295 6 804-824Ämneskategorier (SSIF 2011)
Omvårdnad
Gerontologi, medicinsk/hälsovetenskaplig inriktning
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
DOI
10.1111/joim.13784