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A Performance Measurement Framework for Integrated Care Networks

Authors:

Reham Abdelhalim ,

IHPME, CA
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Suman Budhwani,

CA
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Patrick Feng,

CA
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G Ross Baker

CA
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Abstract

Introduction

Despite the widespread adoption of integrated care initiatives, achieving integrated care goals remains elusive. One continuing challenge is the frequent mismatch between measurement frameworks and goals.  Existing literature describes conceptual frameworks or measurement domains without identifying specific measures, or, alternatively, reviews existing measures and measuring tools without explicating how these measures could be used or how they fit together in a performance measurement framework.  We sought to develop a performance measurement framework for integrated care initiatives with linked measures that can be adapted to different initiatives and settings and which informs strategy and guides decision-making.

Aims Objectives Theory or Methods

We conducted a scoping a review of peer-reviewed studies and grey literature articles to identify performance measurement frameworks, measurement domains and measures for integrated care.  Measures were abstracted and categorized based on structure, process and outcomes; outcomes were further classified based on quadruple aim domains. Thematic analysis was conducted based on recommended measurement domains and subdomains in the literature.  This was summarized in an overarching performance measurement framework using a logic model format.  Further mapping and analysis of measures was conducted onto the proposed measurement framework based on discussion between study authors and feedback from local policy-makers

Highlights or Results or Key Findings

The initial scoping review search found over 2600 articles; of these, 278 were deemed potentially relevant and screened, resulting in the inclusion of 70 articles. A total of 340 measures of integrated care were found in these 70 articles. Most of these measures were existing outcome measures; and these measures were not directly linked to integrated care initiatives.

A performance measurement framework was constructed including process and outcome measurement domains and subdomains. Process measures were divided into 1) measures of key integrated care activities including personalized care, coordinated care, and interprofessional collaboration, and 2) critical outputs including patient empowerment, communication, continuity of care, planned care, and access. Outcomes domains were mapped to the quadruple aim and included user experience (patient, caregiver), provider experience, health outcomes (system-level, person-level), and cost/utilization. Few measures were found that tapped policy environment, context and initiative structure components.

Conclusions

Despite the substantial literature on integrated care measurement, many current measures are poorly suited to the task of measuring integrated care. We propose a performance measurement framework for integrated care initiatives that provides a conceptually grounded and useful approach for evaluating integrated care.

Implications for applicability/transferability sustainability and limitations

Performance measurement of integrated care initiatives is a complex task. We propose a performance measurement framework and linked performance measures that can be utilized to guide implementation and development, informing practitioners, policy makers, funders and evaluators who seek to assess the performance of integrated care efforts.

How to Cite: Abdelhalim R, Budhwani S, Feng P, Baker GR. A Performance Measurement Framework for Integrated Care Networks. International Journal of Integrated Care. 2022;22(S2):178. DOI: http://doi.org/10.5334/ijic.ICIC21263
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Published on 16 May 2022.

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