Instruments Measuring Integrated Care: A Systematic Review of Measurement Properties

Abstract

Policy Points:r Investigations on systematic methodologies for measuring integrated care should coincide with the growing interest in this field of research.r A systematic review of instruments provides insights into integrated care measurement, including setting the research agenda for validating available instruments and informing the decision to develop new ones.r This study is the first systematic review of instruments measuring integrated care with an evidence synthesis of the measurement properties.r We found 209 index instruments measuring different constructs related to integrated care; the strength of evidence on the adequacy of the majority of their measurement properties remained largely unassessed. Context:Integrated care is an important strategy for increasing health system performance. Despite its growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague and limited. Our systematic review aims to provide evidence on the state of the art in measuring integrated care. Methods:Our comprehensive systematic review framework builds on the Rainbow Model for Integrated Care (RMIC). We searched MEDLINE/PubMed for published articles on the measurement properties of instruments measuring integrated care and identified eligible articles using a standard set of selection

Indicators and Measurement Tools for Health Systems Integration: A Knowledge Synthesis

“…The findings are consistent with other reviews that have uncovered a vast number of instruments related to the concepts of care coordination and patient-centred care [1020]. This is perhaps not surprising; these domains are the focus for many health care system reforms as progress in these areas directly influence patient care and experience [152].…”

“…The lack of measurement tools in these domains is consistent with findings from the literature. For example, in Bautista’s comprehensive review [10], less than 8% of tools touched on these dimensions. Similarly, the findings from Lyngsø et al 2014 [2] would suggest that these remain poorly measured aspects of integrated care, pointing to an important evidence gap.…”

“…This has been attributed to ongoing conceptual ambiguity of integrated care and what successful integration looks like in different contexts [23101112]. Continued progress towards integrated care will depend much on our ability to contrast and compare the impact of strategies across different levels and context.…”

“…Besides conceptual ambiguity, measuring integrated care is challenging because of a lack of tools to measure different aspects of integration and inherent difficulties in tracking down existing tools within a dispersed body of literature [1516]. Being able to measure and evaluate the success of integration strategies in a consistent way is essential to effectively advance the design and implementation of an integrated health system [10]. …”

“…Our review will contribute to the growing body of literature concerned with measuring progress towards fully integrated systems [2310181920] and will offer a useful resource to health system planners and decision-makers.…”