Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-23T20:21:20.383Z Has data issue: false hasContentIssue false
  • English
  • Français

Integrated Care Approaches Used for Transitions from Hospital to Community Care: A Scoping Review

Published online by Cambridge University Press:  10 April 2018

Cara L. Brown Open the ORCID record for Cara L. Brown [Opens in a new window]  and
Verena Menec
Cara L. Brown*
Affiliation:
Department of Community Health Sciences, Faculty of Health Sciences, University of Manitoba
Verena Menec
Affiliation:
Department of Community Health Sciences, Faculty of Health Sciences, University of Manitoba
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Cara L. Brown, M.Sc. Department of Community Health Sciences Max Rady College of Medicine Faculty of Health Sciences University of Manitoba R106, 771 McDermot Ave. Winnipeg, MB R3E 0T6 <cara.brown@umanitoba.ca>
Get access Rights & Permissions [Opens in a new window]

Abstract

Integrated care is a promising approach for improving care transitions for older adults, but this concept is inconsistently defined and applied. This scoping review describes the size and nature of literature on integrated care initiatives for transitions from hospital to community care for older adults (aged 65 and older) and how this literature conceptualizes integrated care. A systematic search of literature from the past 10 years yielded 899 documents that were screened for inclusion by two reviewers. Of the 48 included documents, there were 26 journal articles and 22 grey literature documents. Analysis included descriptive statistics and a content analysis approach to summarize features of the integrated care initiatives. Results suggest that clinical and service delivery integration is being targeted rather than integration of funding, administration, and/or organization. To promote international comparison of integrated care initiatives aiming to improve care transitions, detailed descriptions of organizational context are also needed.

Résumé

Les soins intégrés constituent une approche prometteuse pour améliorer les transitions entre les soins pour les personnes âgées, mais il n’existe pas de consensus concernant ce concept ou ses applications. Cet examen de la portée décrit l’ampleur et le contenu des publications sur les initiatives de soins intégrés visant les transitions entre les soins hospitaliers et les soins en milieu communautaire pour les aînés (âgés de 65 ans ou plus), et la conceptualisation des soins intégrés dans ces écrits. Une recherche systématique dans la littérature des 10 dernières années a permis d’identifier 899 documents qui ont été examinés par deux évaluateurs. Des 48 documents sélectionnés, 26 étaient des articles de revues scientifiques et 22 des articles de la littérature grise.

Les analyses réalisées incluent des statistiques descriptives et une analyse de contenu qui résume les caractéristiques des initiatives de soins intégrés. Les résultats suggèrent que l’intégration de la prestation des soins et services est principalement visée par ces travaux, plutôt que l’intégration du financement, de l’administration ou de l’organisation des soins. Afin de permettre des comparaisons sur le plan international des initiatives de soins intégrés visant l’amélioration des transitions entre les soins, une description détaillée des contextes organisationnels serait aussi nécessaire.

Keywords

agingintegrated carecare transitionscare coordinationhospital carecommunity-based carevieillissementsoins intégréstransitions entre les soinscoordination des soinssoins hospitalierssoins en milieu communautaire
Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 37 , Issue 2 , June 2018 , pp. 145 - 170
Copyright
Copyright © Canadian Association on Gerontology 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Janice Linton, University of Manitoba Health Sciences librarian, provided invaluable advice regarding the systematic search strategy for this work. Thank you to the Centre on Aging at the University of Manitoba, and the Canadian Occupational Therapy Foundation for scholarship support of Cara Brown’s doctoral studies. Brown’s doctoral studies are also supported in part by a Health Research Graduate Studentship from Research Manitoba.

References

Altfeld, S., Pavle, K., Rosenberg, W., & Shure, I. (2012). Integrating care across settings: The Illinois transitional care consortium’s bridge model. Generations, 36(4), 98–101. Retrieved from http://www.asaging.org/blog/integrating-care-across-settings-illinois-transitional-care-consortium%E2%80%99s-bridge-modelGoogle Scholar
Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8: 19–31. doi:10.1080/1364557032000119616CrossRefGoogle Scholar
Armitage, G. D., Suter, E., Oelke, N. D., & Adair, C. E. (2009). Health systems integration: state of the evidence. International Journal of Integrated Care, 9(2). doi:http://doi.org/10.5334/ijic.316CrossRefGoogle ScholarPubMed
Asmus-Szepesi, K. (2015). Prevention of functional declines among hospitalized older people ( Doctoral dissertation). Retrieved from http://www.erasmusmc.nl/cs-research/subsidies/3600331/thesicompleetkirstenasmusGoogle Scholar
Asmus-Szepesi, K., Flinterman, L., Koopmanschap, M., Nieboer, A., Bakker, T., Mackenbach, J., & Steyerberg, E. (2015). Evaluation of the prevention and reactivation care program (PreCaP) for the hospitalized elderly: A prospective nonrandomized controlled trial. Clinical Interventions in Aging, 10, 649–661. doi:10.2147/CIA.S77677CrossRefGoogle ScholarPubMed
Asmus-Szepesi, K. J. E., De Vreede, Paul L., Nieboer, A. P., Van Wijngaarden, J. D. H., Bakker, T. J. E. M., Steyerberg, E. W., & Mackenbach, J. P. (2011). Evaluation design of a reactivation care program to prevent functional loss in hospitalised elderly: A cohort study including a randomised controlled trial (Study protocol; Clinical report). BMC Geriatrics, 11, 36.CrossRefGoogle Scholar
Bäck, M., & Calltorp, J. (2015). The Norrtaelje model: A unique model for integrated health and social care in Sweden. International Journal of Integrated Care, 15(6), E016. doi:http://doi.org/10.5334/ijic.2244CrossRefGoogle Scholar
Baillie, L., Gallini, A., Corser, R., Elworthy, G., Scotcher, A., & Barrand, A. (2014). Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: A qualitative case study. International Journal of Integrated Care, 14, E009. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027893/CrossRefGoogle Scholar
Baird Kanaan, S. (2009). Homeward bound: Nine patient-centered programs cut readmissions. Oakland, CA: California HealthCare Foundation. Retrieved from https://www.bu.edu/fammed/projectred/publications/ReducingReadmissionsCaseStudies.pdfGoogle Scholar
British Columbia Provincial Seniors Hospital Care Working Group (2012). Hospital care for seniors clinical care management guideline: 48/6 model of care. Retrieved from https://bcpsqc.ca/documents/2012/10/Complete-48-6-package_-v6.docGoogle Scholar
Government of British Columbia. (2012) Hospital care for seniors: 48/6 approach. Retrieved from https://bcpsqc.ca/documents/2012/10/Key-Messages-for-48_6-24Sept2012-1.pdfGoogle Scholar
Béland, F., Bergman, H., Lebel, P., Clarfield, A. M., Tousignant, P., Contandriopoulos, A., & Dallaire, L. (2006). A system of integrated care for older persons with disabilities in Canada: Results from a randomized controlled trial. The Journals of Gerontology, Series A, 61(4), 367–373. Retrieved from https://doi.org/10.1093/gerona/61.4.367CrossRefGoogle ScholarPubMed
Bergmo, T., Berntsen, G., Dalbakk, M., & Rumpsfeld, M. (2015). The effectiveness and cost effectiveness of the PAtient-Centred Team (PACT) model: Study protocol of a prospective matched control before-and-after study. BMC Geriatrics, 15, 133. doi:10.1186/s12877-015-0133-xCrossRefGoogle ScholarPubMed
Buurman, B. M., Parlevliet, J. L., van Deelen, B. A., de Hann, R. J., & de Rooij, S. E. (2010). A randomized clinical trial on a comprehensive geriatric assessment and intensive home follow-up after hospital discharge: The transitional care bridge. BMC Health Services Research, 10, 296. doi:10.1186/1472-6963-10-296CrossRefGoogle ScholarPubMed
Calciolari, S., & Ilinca, S. (2011). Comparing (and learning from) integrated care initiatives: An analytical framework. Journal of Integrated Care, 19(6), 4–13. doi.org/10.1108/14769011111191412CrossRefGoogle Scholar
Canadian Institute of Health Information (CIHI). (2012). All-cause readmission to acute care and return to the Emergency Department. Ottawa, ON: Author. Retrieved from https://secure.cihi.ca/estore/productFamily.htm?locale=en&pf=PFC1823Google Scholar
Casas, A., Troosters, T., Garcia-Aymerich, J., Roca, J., Hernández, C., Alonso, A., … Decramer, M. (2006). Integrated care prevents hospitalisations for exacerbations in COPD patients. The European Respiratory Journal, 28(1), 123–130. 10.1183/09031936.06.00063205CrossRefGoogle ScholarPubMed
Chia, B., Abraham, M., Seong, L., & Cheah, J. (2012) No longer lost in transition? Annals Academy of Medicine, 41(11), 479–482.Google ScholarPubMed
Cunnane, D. (2013). Study visit Sweden and Denmark. Kernow, ENG: NHS Kernow Clinical Commissioning Group. Retrieved from http://knowledgebucket.org/wp-content/uploads/2014/12/Denmark-and-Sweden.pdfGoogle Scholar
Chappell, N. L., & Hollander, M. J. (2013). Aging in Canada. Don Mills, ON: Oxford University Press.Google Scholar
Constand, M., MacDermid, J., Dal Bello-Haas, V., & Law, M. (2014). Scoping review of patient-centered care approaches in healthcare. BMC Health Services Research, 14, 271. Retrieved from https://doi.org/10.1186/1472-6963-14-271CrossRefGoogle ScholarPubMed
Dahl, U., Steinsbekk, A., Jenssen, S., & Johnsen, R. (2014). Hospital discharge of elderly patients to primary health care, with and without an intermediate care hospital – A qualitative study of health professionals’ experiences. International Journal of Integrated Care, 14, E011. Retrieved from http://doi.org/10.5334/ijic.1156CrossRefGoogle Scholar
Department of Health. (2009). Integrated pilots: An introductory guide. London, ENG. Retrieved from http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_106206.pdfGoogle Scholar
de Vos, A., Asmus-Szepesi, K., Bakker, T., de Vreede, P., van Wijngaarden, J., Steyerberg, E., … Nieboer, A. P. (2012). Integrated approach to prevent functional decline in hospitalized elderly: The Prevention and Reactivation Care Program (PReCaP). BMC Geriatrics, 12(7). doi:10.1186/1471-2318-12-7CrossRefGoogle ScholarPubMed
Doshi, H., Ramason, K., Azellarasi, R., Naidu, J., & Chan, G. (2014). Orthogeriatric model for hip fracture patients in Singapore: Our early experience and initial outcomes. Archives of Orthopaedic and Trauma Surgery, 134(3), 351–357. doi:10.1007/s00402-013-1900-9CrossRefGoogle ScholarPubMed
Eklund, K., Wilhelmson, K., Gustafsson, H., Landahl, S., & Dahlin-Ivanoff, S. (2013). One-year outcome of frailty indicators and activities of daily living following the randomised controlled trial; “Continuum of care for frail older people”. BMC Geriatrics, 13:76. doi:10.1186/1471-2318-13-76CrossRefGoogle Scholar
Forster, A. J., Clark, H. D., Menard, A., Dupuis, N., Chernish, R., Chandok, N., … & van Walraven, C. (2004). Adverse events among medical patients after discharge from hospital. Canadian Medical Association Journal, 170(3), 345–349.Google ScholarPubMed
Glasby, J., Littlechild, R., Le Mesurier, N., Thwaites, R., Oliver, D., Jones, S., & Wilkinson, I. (2016). Who knows best? Older people’s contribution to understanding and preventing avoidable hospital admissions. Birmingham, ENG: University of Birmingham. Retrieved from http://www.birmingham.ac.uk/Documents/college-social-sciences/social-policy/HSMC/publications/2016/who-knows-best.pdfGoogle Scholar
Gonçalves-Bradley, D. C., Lannin, N. A., Clemson, L. M., Cameron, I. D., & Shepperd, S. (2016). Discharge planning from hospital. The Cochrane Database of Systematic Reviews, (1), CD000313.Google ScholarPubMed
Gröne, O., & Garcia-Barbero, M. (2001). Integrated care: A position paper of the WHO European Office for Integrated Health Care Services. International Journal of Integrated Care, 1, E21.CrossRefGoogle ScholarPubMed
Hjelmar, U., Hendriksen, C., & Hansen, K. (2011). Motivation to take part in integrated care-an assessment of follow-up home visits to elderly persons. International Journal of Integrated Care, 11, E122.CrossRefGoogle ScholarPubMed
Holstege, M., Caljouw, M., Zekveld, I., Van Balen, R., De Groot, A., Van Haastregt, J., … Achterberg, W. (2015). Changes in geriatric rehabilitation: A national programme to improve quality of care. The Synergy and Innovation in Geriatric Rehabilitation study. International Journal of Integrated Care, 15, E045.CrossRefGoogle ScholarPubMed
Hounslow and Richmond Community Healthcare NHS Trust (HRCH). (2013). Moving towards integrated care: A study of the feasibility of integrating community health and social care in Hounslow and Richmond. Retrieved from www.hrch.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=5154Google Scholar
Hollander, M. J., & Prince, M. J. (2007). Organizing healthcare delivery systems for persons with ongoing care needs and their families: A best practices framework. Healthcare Quarterly, 11(1), 42–52.Google Scholar
Jackson, K., Oelke, N. D., Besner, J., & Harrison, A. (2012). Patient journey: Implications for improving and integrating care for older adults with chronic obstructive pulmonary disease. Canadian Journal on Aging, 31(2), 223–233. doi:10.1017/S0714980812000086CrossRefGoogle ScholarPubMed
Joanna Briggs Institute. (2015). The Joanna Briggs Institute Reviewers’ Manual 2015. Supplement: Methodology for JBI Scoping reviews. Adelaide, AUS: The University of Adelaide. Retrieved from http://joannabriggs.org/assets/docs/sumari/Reviewers-Manual_Methodology-for-JBI-Scoping-Reviews_2015_v2.pdfGoogle Scholar
Joint Improvement Team. (2015). Home first: Ten actions to transform discharge. Edinburgh, GBR. Retrieved from http://www.jitscotland.org.uk/resource/home-first-ten-actions-transform-discharge/Google Scholar
Johannessen, A., Lurås, H., & Steihaug, S. (2013). The role of an intermediate unit in a clinical pathway. International Journal of Integrated Care, 13, E012.CrossRefGoogle Scholar
Knight, D. A., Thompson, D., Mathie, E., & Dickinson, A. (2011). ‘Seamless care? Just a list would have helped!’ Older people and their carer’s experiences of support with medication on discharge home from hospital. Health Expectations, 16, 277–291. doi:10.1111/j.1369-7625.2011.00714.xCrossRefGoogle ScholarPubMed
Kodner, D. L. & Spreeuwenberg, C. (2002). Integrated care: Meaning, logic, applications, and implications: A discussion paper. International Journal of Integrated Care, 12(2), 1–6.Google Scholar
Lapum, J., Angus, J. E., Peter, E., & Watt-Watson, J. (2011). Patients’ discharge experiences: Returning home after open-heart surgery. Heart & Lung, 40(3), 226–235. doi:10.1016/j.hrtlng.2010.01.001CrossRefGoogle ScholarPubMed
Laugaland, K., Aase, K., & Barach, P. (2012). Interventions to improve patient safety in transitional care: A review of the evidence. Work, 41, 2915–2924. doi:10.3233/WOR-2012-0544-2915CrossRefGoogle ScholarPubMed
Lee, K. H., Low, L. L., Allen, J., Barbier, S., Ng, L. B., Ng, M. J. M., … Tan, S. Y. (2015). Transitional care for the highest risk patients: Findings of a randomised control study. International Journal of Integrated Care, 15, E039.CrossRefGoogle ScholarPubMed
Leppin, A. L., Gionfriddo, M. R., Kessler, M., Pablo Brito, J., Mair, F., Gallacher, K., Wang, Z., … Montori, V.M. (2014). Preventing 30-day hospital readmissions: A systematic review and meta-analysis of randomized trials. Journal of the American Medical Association Internal Medicine, 174(7), 1095–1107. doi:10.1001/jamainternmed.2014.1608Google ScholarPubMed
Leutz, W. (1999). Five laws for integrating medical and social services: Lessons from the United States and the United Kingdom. Milbank Quarterly, 77(1), 77–110.CrossRefGoogle ScholarPubMed
Levac, D., Colquhoun, H., & O’Brien, K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5, 69. https://doi.org/10.1186/1748-5908-5-69CrossRefGoogle ScholarPubMed
Lin, P. C., Wang, J. L., Chang, S. Y., & Yang, F. M. (2005). Effectiveness of a discharge-planning pilot program for orthopedic patients in Taiwan. International Journal of Nursing Studies, 42(7), 723–731. doi:10.1016/j.ijnurstu.2004.10.006CrossRefGoogle ScholarPubMed
Lyon, D., Miller, J., & Pine, K. (2006). The Castlefields integrated care model: The evidence summarized. Journal of Integrated Care, 14(1), 7–13.CrossRefGoogle Scholar
Martínez-González, N., Berchtold, P., Ullman, K., Busato, A., & Egger, M. (2014). Integrated care programmes for adults with chronic conditions: A meta-review. International Journal for Quality in Health Care, 26(5), 561–570. doi:10.1093/intqhc/mzu071CrossRefGoogle ScholarPubMed
Maruthappu, M., Hasan, A., & Zeltner, T. (2015). Enablers and barriers in implementing integrated care. Health Systems & Reform. doi:10.1080/23288604.2015.1077301CrossRefGoogle ScholarPubMed
Masters, S., Halbert, J., Crotty, M., & Cheney, F. (2008). Innovations in aged care: What are the first quality reports from the Transition Care Program in Australia telling us? Australasian Journal on Ageing, 27(2), 97–102. doi:10.1111/j.1741-6612.2008.00285.xCrossRefGoogle Scholar
Mitchell, G., Burridge, L., Zhang, J., Donald, M., Scott, I., Dart, J., & Jackson, C. (2015). Systematic review of integrated models of health care delivered at the primary-secondary interface: How effective is it and what determines effectiveness? Australian Journal of Primary Health, 21(4), 391–408. doi:10.1071/PY14172CrossRefGoogle ScholarPubMed
National Health Service (NHS) Forth Valley. (2012). Initial agreement for a care village in Stirling. Retrieved from http://nhsforthvalley.com/wp-content/uploads/2014/01/Stirling-Care-Village-Initial-Agreement.pdfGoogle Scholar
National Voices. (n.d.) A narrative for person-centred coordinated care. London, ENG: NHS England. Retrieved from https://www.england.nhs.uk/wp-content/uploads/2013/05/nv-narrative-cc.pdfGoogle Scholar
NHS England. (2014). Integrated care pioneer programme annual report 2014: Pioneer profiles and case study examples. London, ENG: Author. Retrieved from https://www.local.gov.uk/sites/default/files/documents/integrated-health-and-car-721.pdfGoogle Scholar
NHS West London Clinical Commissioning Group. (2015). Whole systems integrated care: For the over 75s. West London, ENG: Author. Retrieved from http://www.westlondonccg.nhs.uk/media/11372/04.1.a__wlccg_wsic__over_75s__early_adopter_ws_outline_plan_-_master.pdf.Google Scholar
Oelke, N., Suter, E., Da Silva Lima, M., & Van Vliet-Brown, C. (2015). Indicators and measurement tools for health system integration: A knowledge synthesis protocol. Systematic Reviews, 4, 99. https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-015-0090-7CrossRefGoogle ScholarPubMed
Ontario Association of Community Care Access Centres. (2013). Health comes home: A conversation about aging and chronic care: Part 2. Toronto, ON: Author. Retrieved from http://hssontario.ca/News/Lists/PublicationsDocument/HealthComesHomePart2.pdfGoogle Scholar
Ontario Behavioural Support Systems Project Team (2010). Behaviors have meaning. Toronto, ON: Author. Retrieved from http://www.nelhin.on.ca/Page.aspx?id=12028Google Scholar
O’Sullivan, S. (2014). Implementation of a revised interim home support protocol for older persons in the south (Master’s thesis). Dublin, IRL: Royal College of Surgeons in Ireland. Retrieved from http://epubs.rcsi.ie/cgi/viewcontent.cgi?article=1042&context=msctthesesGoogle Scholar
Preen, D., Bailey, B., Wright, A., Kendall, P., Phillips, M., Hung, J., … Williams, E. (2005). Effects of a multidisciplinary, post-discharge continuance of care intervention on quality of life, discharge satisfaction, and hospital length of stay: A randomized controlled trial. International Journal for Quality in Health Care, 17(1), 43–51.CrossRefGoogle ScholarPubMed
RAND Europe. (2012). National evaluation of the department of health’s integrated care pilots. Cambridge, ENG: Author. Retrieved from https://www.gov.uk/government/publications/national-evaluation-of-department-of-healths-integrated-care-pilotsGoogle Scholar
Rennke, S., Nguyen, O. K., Shoeb, M. H., Magan, Y., Wachter, R. M., & Ranji, S. R. (2013). Hospital-initiated transitional care intervention as a patient safety strategy: A systematic review. Annals of Internal Medicine, 158(5, Pt 2), 433–440. doi:10.7326/0003-4819-158-5-201303051-00011CrossRefGoogle ScholarPubMed
Roland, M., Lewis, M., Steventon, A., Abel, G., Adams, J., Bardsley, M., … Ling, T. (2012). Case management for at-risk elderly patients in the English integrated care pilots: Observational study of staff and patient experience and secondary care utilisation. International Journal of Integrated Care, 12(5). E130.CrossRefGoogle ScholarPubMed
Royal College of Physicians. (2013). Future hospital: Caring for medical patients. London, ENG: Author. Retrieved from https://www.rcplondon.ac.uk/projects/outputs/future-hospital-commissionGoogle Scholar
Snowdon, A., & Cohen, J. (2011). Strengthening health systems through innovation: Lessons learned. London, ON: International Centre for Health Innovation. Retrieved from http://sites.ivey.ca/healthinnovation/files/2011/11/GlobalHealthSystemsWhitePaperFINAL.pdfGoogle Scholar
Strategy and Implementation Group for Nottingham South (SIGNS). (n.d.). Greater Nottingham’s vision of integrated care for older people. Nottingham, ENG: Author. Accessed from http://www.nottinghamshire.gov.uk/Google Scholar
Tate, P. (2015). Change and innovation fund proposal: Developing specialist care of the elderly clinical leadership within communities in Dumfries and Galloway. Dumfries, ENG: NHS Dumfries and Galloway.Google Scholar
Thistlethwaite, P. (2011). Integrating health and social care in Torbay: Improving care for Mrs. Smith. London, ENG: The King’s Fund. Retrieved from https://www.kingsfund.org.uk/sites/files/kf/integrating-health-social-care-torbay-case-study-kings-fund-march-2011.pdfGoogle Scholar
Titova, E., Steinshamn, S., Indredavik, B., & Henriksen, A. (2015). Long term effects of an integrated care intervention on hospital utilization in patients with severe COPD: A single center controlled study. Respiratory Research, 16(8), 1–10. doi:10.1186/s12931-015-0170-1CrossRefGoogle Scholar
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K., Colquhoun, H., Kastner, M., … Straus, S. E. (2016). A scoping review on the conduct and reporting of scoping reviews. BMC Medical Research Methodology, 16(15). Retrieved from https://doi.org/10.1186/s12874-016-0116-4CrossRefGoogle ScholarPubMed
Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398–405.CrossRefGoogle ScholarPubMed
Valentijn, P., Schepman, S., Opheij, W., & Bruijnzeels, M. (2013). Understanding integrated care: A comprehensive conceptual framework based on the integrative functions of primary care. International Journal of Integrated Care, 13, e010.CrossRefGoogle ScholarPubMed
Vedel, I., Monette, M., Beland, F., Monette, J., & Bergman, H. (2011). Ten years of integrated care: Backwards and forwards. The case of the province of Québec, Canada. International Journal of Integrated Care, 11(7), 1–11. Retrieved from http://www.ijic.org/articles/abstract/10.5334/ijic.574/CrossRefGoogle ScholarPubMed
Walker, D. (2011). Caring for our aging population and addressing alternate level of care: Report submitted to the minister of health and long-term care. Toronto, ON: Ministry of Health and Long-Term Care. Retrieved from http://www.health.gov.on.ca/en/common/ministry/publications/reports/walker_2011/walker_2011.aspxGoogle Scholar
Williams, D. (2015). Report to the Glasgow City Council/NHS Greater Glasgow and Clyde shadow integration joint board: Integrated care pathway for older people. Glasgow, UK. Retrieved from https://www.glasgow.gov.uk/CHttpHandler.ashx?id=29837&p=0Google Scholar
Wong, F., Chau, J., So, C., Tam, S., & McGhee, S. (2012). Cost-effectiveness of a health-social partnership transitional program for post-discharge medical patients. BMC Health Services Research, 12, 479. doi:10.1186/1472-6963-12-479CrossRefGoogle ScholarPubMed
Wong, F. K., Ho, M. M., Yeung, S., Tam, S. K., & Chow, S. K. (2011). Effects of a health-social partnership transitional program on hospital readmission: A randomized controlled trial. Social Science & Medicine, 73(7), 960–969. doi:10.1016/j.socscimed.2011.06.036CrossRefGoogle ScholarPubMed
World Health Organization (WHO). (2015). World report on ageing and health. Retrieved from http://apps.who.int/iris/bitstream/10665/186463/1/9789240694811_eng.pdfGoogle Scholar