Towards an integrated care measurement

Abstract

Although a shift towards care that is more integrated is required, the concept of integrated care is ambiguous. Consequently, an instrument to systematically describe and measure integrated care is not yet available. The objective of this study was to develop a preliminary version of this instrument. We performed a systematic literature review and a 2-round Delphi study among Dutch scientific and field experts on integrated care. Based on this study 40 determinants were identified, operationalization of these determinants led to an instrument containing 89 items. A first assessment of the instruments usability and validity was executed on 15 reports, with a fixed format and predefined objectives, of integrated care projects from national programs on elderly care, community nurses and disease management. Assessment of this instrument showed the diverse nature of integrate care in practice. Also, it provided many suggestions for improving the instrument. The preliminary instrument is an important first step in specifying integrated care and making the concept measurable. Such an instrument can benefit policy makers as well as funding agencies and health insurers. Further development requires (international) validation and evidence. Therefore, application of the instrument in Singapore and Belgium is planned in the near future.