Integrated care is recognised as a global movement in transforming care systems and practice to promote person-centred care, but its impact still remains difficult to measure. Recently, Vilans researchers published an editorial paper in the International Journal of Integrated Care (IJIC) addressing this challenge and possible ways to overcome this.
According to researcher Nick Zonneveld, there are both academic and real world challenges to measure the impact of integrated care. ‘We are working on integrated care for over twenty years now. There have been a lot of collaborations, projects and interesting studies. For instance in the Netherlands, we have programmes like Regiokracht, Medisch Generalistische Zorg, The Right Care at the Right Place’ et cetera. But one of the main problems is still demonstrating solid and balanced evidence that it really works.’
Researcher and co-author Ephrem Tesfay adds: ‘This stems from the complexity in that, there is often little consensus on what input to measure at the start of an integrated care project and what output to measure at the end of it. For example, do we mainly measure cost reduction or do we also measure quality of life or other outcomes? And what balanced mix of outcomes is the most appropriate?’
Zonneveld: ‘It is not as easy as taking a pill and then measuring its effects afterwards. Integrated care varies highly on context, implementation and range of interventions and we sometimes don’t agree on what’s inside the pill. Meaning there is no ‘all inclusive’ comprehensive framework that captures the impact of integrated care.’
Three complexities to overcome
In their IJIC editorial, the researchers discuss three steps to overcome this issues. Mirella Minkman, co-author and IJIC-editorial board member adds: ‘Our analysis and discussion highlight the complexity of moving from principles of integrated care to measuring real live impact. Our arguments emphasise the importance of first identifying what impact means to different stakeholders. Second, employing appropriate tools and a Theory of Change to capture different aspects of impact and involving key stakeholders in this process. And third, ensuring a sufficient and suitable (extended) timeframe for a comprehensive assessment of integrated care impact.’
For the full analysis, read the article ‘Measuring the Impact of Integrated Care: from Principles to Real-World Impact’ on IJIC.