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dc.contributor.authorBerntsen, Gro Karine Rosvold
dc.contributor.authorHøyem, Audhild
dc.contributor.authorLettrem, Idar
dc.contributor.authorRuland, Cornelia
dc.contributor.authorRumpsfeld, Markus
dc.contributor.authorGammon, Barbara Deede
dc.date.accessioned2019-03-11T09:20:02Z
dc.date.available2019-03-11T09:20:02Z
dc.date.issued2018-06-20
dc.description.abstract<p><i>Background</i>: Person-Centered Integrated Care (PC-IC) is believed to improve outcomes and experience for persons with multiple long-term and complex conditions. No broad consensus exists regarding how to capture the patient-experienced quality of PC-IC. Most PC-IC evaluation tools focus on care events or care in general. Building on others’ and our previous work, we outlined a 4-stage goal-oriented PC-IC process ideal: 1) Personalized goal setting 2) Care planning aligned with goals 3) Care delivery according to plan, and 4) Evaluation of goal attainment. We aimed to explore, apply, refine and operationalize this quality of care framework. <p> <p><i>Methods</i>: This paper is a qualitative evaluative review of the individual Patient Pathways (iPP) experiences of 19 strategically chosen persons with multimorbidity in light of ideals for chronic care. The iPP includes all care events, addressing the persons collected health issues, organized by time. We constructed iPPs based on the electronic health record (from general practice, nursing services, and hospital) with patient follow-up interviews. The application of the framework and its refinement were parallel processes. Both were based on analysis of salient themes in the empirical material in light of the PC-IC process ideal and progressively more informed applications of themes and questions. <p> <p><i>Results</i>: The informants consistently reviewed care quality by how care supported/ threatened their long-term goals. Personal goals were either implicit or identified by “What matters to you?” Informants expected care to address their long-term goals and placed responsibility for care quality and delivery at the system level. The PC-IC process framework exposed system failure in identifying long-term goals, provision of shared long-term multimorbidity care plans, monitoring of care delivery and goal evaluation. The PC-IC framework includes descriptions of ideal care, key questions and literature references for each stage of the PC-IC process. This first version of a PC-IC process framework needs further validation in other settings. <p> <p><i>Conclusion</i>: Gaps in care that are invisible with event-based quality of care frameworks become apparent when evaluated by a long-term goal-driven PC-IC process framework. The framework appears meaningful to persons with multimorbidity.<p>en_US
dc.description.sponsorshipRegional health authoritiesen_US
dc.descriptionSource at <a href=https://doi.org/10.1186/s12913-018-3246-z>https://doi.org/10.1186/s12913-018-3246-z. </a> © The Author(s). 2018en_US
dc.identifier.citationBerntsen, G., Høyem, A., Lettrem, I., Ruland, C., Rumpsfeld, M. & Gammon, D. (2018). A person-centered integrated care quality framework, based on a qualitative study of patients' evaluation of care in light of chronic care ideals. <i>BMC Health Services Research</i>, 18:479. https://doi.org/10.1186/s12913-018-3246-zen_US
dc.identifier.cristinIDFRIDAID 1592826
dc.identifier.doi10.1186/s12913-018-3246-z
dc.identifier.issn1472-6963
dc.identifier.urihttps://hdl.handle.net/10037/14925
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.ispartofHøyem, A. (2019). Continuity of care for patients with long-term complex needs - implications for clinical hospital practice. (Doctoral thesis). <a href=https://hdl.handle.net/10037/15401>https://hdl.handle.net/10037/15401</a>
dc.relation.journalBMC Health Services Research
dc.relation.projectIDinfo:eu-repo/grantAgreement/RCN/IKTPLUSS/201512/Norway/Flexible Collaborative Networks and Patient-Provider Partnerships in Health Care: Critical Factors//en_US
dc.rights.accessRightsopenAccessen_US
dc.subjectPerson-centered careen_US
dc.subjectDelivery of healthcareen_US
dc.subjectIntegrated careen_US
dc.subjectHealth service researchen_US
dc.subjectMultimorbidityen_US
dc.subjectLong-term conditionsen_US
dc.subjectEvaluation researchen_US
dc.subjectCare processen_US
dc.subjectGoal attainmenten_US
dc.subjectContinuity of careen_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800en_US
dc.titleA person-centered integrated care quality framework, based on a qualitative study of patients' evaluation of care in light of chronic care idealsen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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