Abstract
This thesis aimed to explore the (cost-)effectiveness of preventive, integrated care for community-dwelling frail older people. The first part of this thesis focused on the effectiveness and cost-effectiveness of a specific preventive integrated care intervention, the Walcheren Integrated Care Model (WICM). The second part of this thesis critically reflected on the concepts and methodologies used to explore the (cost-)effectiveness of integrated care for frail older people. This second part included a systematic review and an exploration of the effectiveness of integrated care for six profiles of frail older people.
Highlights
The first part of this thesis focused on the Walcheren Integrated Care Model (WICM) that was implemented in three GP practices in Walcheren, a region in the south-west of the Netherlands
These frailty profiles were included as subgroups in an individual-patient-data analysis of eight integrated care interventions in Dutch primary care to explore whether integrated care is more effective for specific profiles of frail older people
The results of the WICM were in line with the outcomes of other preventive, integrated care interventions included in the systematic review
Summary
Facing Frailty: Exploring the Effectiveness of Integrated Care for Frail Older People. This thesis aimed to explore the (cost-)effectiveness of preventive, integrated care for community-dwelling frail older people. The second part of this thesis critically reflected on the concepts and methodologies used to explore the (cost-)effectiveness of integrated care for frail older people. As frail older people suffer from problems in the physical, psychological and social domain, primary care professionals struggle with this increasing complexity and perceive difficulties in providing high quality care. Professionals, policy makers and researchers have high expectations of integrated care and the wide range of aims it is has been claimed to achieve. To assess whether integrated care can meet these high and diverse expectations, this thesis aimed to explore the (cost-)effectiveness of preventive, integrated care for community-dwelling frail older people
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