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The SELFIE Framework for Integrated Care for Multi-Morbidity: development and description.

Autor
Leijten FRM*, Struckmann V*, Van Ginneken E, Czypionka T, Kraus M, Reiss M, Tsiachristas A, Boland M, De Bont A, Bal R, Busse R, Rutten-Van Mölk
Journal
Health Policy

Abstract

BACKGROUND:

The rise of multi-morbidity constitutes a serious challenge in health and social care organisation that requires a shift from disease- towards person-centred integrated care. The aim of the current study was to develop a conceptual framework that can aid the development, implementation, description, and evaluation of integrated care programmes for multi-morbidity.

METHODS:

A scoping review and expert discussions were used to identify and structure concepts for integrated care for multi-morbidity. A search of scientific and grey literature was conducted.

DISCUSSION:

meetings were organised within the SELFIE research project with representatives of five stakeholder groups (5Ps): patients, partners, professionals, payers, and policy makers.

RESULTS:

In the scientific literature 11,641 publications were identified, 92 were included for data extraction. A draft framework was constructed that was adapted after discussion with SELFIE partners from 8 EU countries and 5P representatives. The core of the framework is the holistic understanding of the person with multi-morbidity in his or her environment. Around the core, concepts were grouped into adapted WHO components of health systems: service delivery, leadership & governance, workforce, financing, technologies & medical products, and information & research. Within each component micro, meso, and macro levels are distinguished.

CONCLUSION:

The framework structures relevant concepts in integrated care for multi-morbidity and can be applied by different stakeholders to guide development, implementation, description, and evaluation.

KEYWORDS:

  • Chronic care
  • Comorbidity
  • Conceptual
  • Frail elderly
  • Framework
  • Integrated care
  • Model
  • Multi-morbidity

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