Abstract
There is increasing international research into health and social care services for older people in need of long-term care (LTC), but problems remain with respect to acquiring robust comparative information to enable judgements to be made regarding the most beneficial and cost-effective approaches. The project 'INTERLINKS' ('Health systems and LTC for older people in Europe') funded by the EU 7th Framework programme was developed to address the challenges associated with the accumulation and comparison of evidence in LTC across Europe. It developed a concept and method to describe and analyse LTC and its links with the health and social care system through the accumulation of policy and practice examples on an interactive web-based framework for LTC. This paper provides a critical overview of the theoretical and methodological approaches used to develop and implement the INTERLINKS Framework for LTC, with the aim of providing some guidance to researchers in this area. INTERLINKS has made a significant contribution to knowledge but robust evidence and comparability across European countries remain problematic due to the current and growing complexity and diversity of integrated LTC implementation.
Highlights
There is increasing international research into health and social care services for older people in need of long-term care (LTC), but challenges remain with respect to acquiring robust comparative information to enable judgements to be made regarding the most beneficial and cost-effective approaches [1,2,3]
It would seem that theories and methods to improve coordination have been proposed and implemented but remained patchy [2,4,5,6] restricted in scope to disease management or pilot projects that are not always able to show clear evidence for improvements [7]
While results and findings including a range of practice examples are published elsewhere [3] the purpose of this paper is to provide a critical overview of the theoretical and methodological approaches used to develop and implement the INTERLINKS Framework for LTC, with the aim of providing some methodological guidance to researchers in this area concerning design and application, cross-national collaboration and how to ensure robustness through validation and dissemination issues
Summary
There is increasing international research into health and social care services for older people in need of long-term care (LTC), but challenges remain with respect to acquiring robust comparative information to enable judgements to be made regarding the most beneficial and cost-effective approaches [1,2,3]. It would seem that theories and methods to improve coordination have been proposed and implemented but remained patchy [2,4,5,6] restricted in scope to disease management or pilot projects that are not always able to show clear evidence for improvements [7] While this suggests that models for the identification of good practice across countries are still evolving [8], the complexity of undertaking research in this field cannot be overestimated. Researchers are grappling with differing health reforms and policy imperatives that may require a change of direction or emphasis during the lifetime of projects, restrictions to resource allocation that affect implementation of initiatives, and the increasing complexity of the health conditions suffered by a multi-morbid ageing population.
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