Table 4.
Results of 27 systematic reviews of integrated care for different conditions and outcomes
| No. of reviews with improved outcome/no. of reviews assessing outcomea |
||||
|---|---|---|---|---|
| Outcome | CHF (12 reviews) | Diabetes (7 reviews) | COPD (7 reviews) | Asthma (5 reviews) |
| Clinical | ||||
| Improved glycaemic control | 4/7 | |||
| Improved blood pressure control | 1/4 | |||
| Reduced mortality | 5/8 | 0/3 | ||
| Functional | ||||
| Improved exercise capacity/functionb | 2/2 | 2/3 | 2/4 | 1/3 |
| Patient centred | ||||
| Improved quality of life | 4/8 | 4/5 | 0/5 | 1/2 |
| Higher patient satisfaction | 0/2 | 4/4 | 2/2 | 1/2 |
| Process of care | ||||
| Improved adherence to treatment guidelinesc | 2/5 | 4/6 | 3/3 | 5/5 |
| More regular retinal and foot examinations | 3/7 | |||
| Use of healthcare resources | ||||
| Reduced hospital admissions | 4/6 | 2/3 | 2/5 | 2/3 |
| Reduced readmissions | 5/9 | 2/3 | ||
| Reduced re-admissions or mortality | 2/2 | |||
| Increased time between discharge and readmission | 1/3 | |||
| Reduced length of hospital stay | 4/8 | 1/1 | 4/4 | |
| Reduced number of ED visits | 2/3 | 1/3 | 2/3 | 1/2 |
| Increased use of appropriate medication | 0/2 | |||
| Costs | ||||
| Reduced costs of services | 1/8 | 1/4 | 0/3 | 1/2 |
Only outcomes assessed by at least two reviews are shown.
LDL, low density lipoprotein; ED, emergency department; CHF, chronic heart failure; COPD, chronic obstructive pulmonary disease.
aNumber of reviews showing positive trends or significant (P < 0.05) improvements associated with integrated care models over the number of reviews that examined this outcome.
bExercise capacity, physical activity, functional status, lung function, forced expiratory volume in 1 s (FEV1).
cAdherence to treatments or diets, provider adherence to guidelines including the screening for risk factors or conditions, improved patient self-care and knowledge as a result of improved adherence of providers to guidelines.