Care Integration in Primary Dementia Care Networks: A Longitudinal Mixed-Methods Study

Dorien L Oostra,Marieke Perry,Anne Harmsen,Minke S Nieuwboer,Marcel G M Olde Rikkert

doi:10.5334/ijic.5675

Abstract

Introduction:Currently, care integration for community-dwelling persons with dementia is poor and knowledge on how to effectively facilitate development of integrated dementia care is lacking. The DementiaNet program aims to overcome this with a focus on interprofessional collaboration. The objective of this study is to investigate how care integration in interprofessional primary dementia care networks matures and to identify factors associated with (un)successfully maturation.Theory and methods:A longitudinal mixed-methods study, including 17 primary care networks participating in the DementiaNet study, was performed. Semi-structured interviews based on the Rainbow Model of Integrated Care were conducted at start, at 12- and 24 months. Network maturity scores (range 1–4) were derived from the interviews and qualitative data was used to explain the observed patterns.Results:Networks consisted on average of 9 professionals (range 4–22) covering medical, care and social disciplines. Network maturity yearly increased with 0.29 (95%-CI: 0.20–0.38). Important factors for improvement included getting to know each other’s expertise, having a capable network leader(s), stable network composition and participation of a general practitioner.Conclusions:The DementiaNet approach enables a transition towards more mature networks. Identified success factors provide better understanding of how network maturity can be achieved and gives guidance to future care integration strategies.

Highlights

Care integration for community-dwelling persons with dementia is poor and knowledge on how to effectively facilitate development of integrated dementia care is lacking
We aim to investigate how the DementiaNet approach affects network maturity of these interprofessional primary dementia care networks over time
During the development of the DementiaNet approach (2014), we focused on interprofessional collaboration and network development, which was, at that time, still a novel approach

Summary

Introduction

Care integration for community-dwelling persons with dementia is poor and knowledge on how to effectively facilitate development of integrated dementia care is lacking. The objective of this study is to investigate how care integration in interprofessional primary dementia care networks matures and to identify factors associated with (un)successfully maturation. A longitudinal mixed-methods study, including 17 primary care networks participating in the DementiaNet study, was performed. In later stages of the disease, several professionals of medical, care and social disciplines are involved. Often these professionals work at different organisations, and fragmentation of care is likely to arise [2]. Continuity of care is lacking and there is a low satisfaction with the provided care among professionals, persons with dementia and their informal caregivers [3, 4]

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