Table 1.
Description of the domains of the revised RMIC
| Main domains | Subdomain | Description |
|---|---|---|
| Triple Aim Outcomesa | ||
| Experience of care | Satisfaction | Patient-reported measures addressing the satisfaction (or barriers) of the service delivery. |
| Quality of careb | Factors related to the quality of care (e.g. patient safety, timeliness, responsiveness, accessibility). | |
| Population health | Mortality | Health outcomes related to mortality measures for a general or specific (sub)population (e.g. life expectancy, standardized mortality, healthy life expectancy). |
| Morbidity | Health outcomes related to patient reported functional status measures (e.g. HRQOL-4, SF-12, EuroQol). | |
| Disease Burden | Health outcomes related to the incidence and prevalence of (major) chronic conditions (e.g. diabetes, heart diseases, chronic obstructive pulmonary disease). | |
| Behavioural factors | Health outcomes related to behavioural factors (e.g. smoking, diet and physical activity) | |
| Physiological factors | Health outcomes related to physiological factors (e.g. body mass index, cholesterol and blood glucose). | |
| Cost and utilization | Cost per capita | Total (direct and indirect) costs and costs by type of service of a particular population per time unit (month, year). |
| Utilization of services | Total volume of service use visits (e.g. number of hospital, emergency department) for per a particular population per time unit (month, year). | |
| RMIC domainsc | ||
| Scale of integration | Universal population (macro) | Universal strategies and interventions designed to promote the general health or reduce the risk of developing health problems in a population. |
| Targeted sub-groups (meso) | Targeted strategies and interventions designed for a subpopulations at risk (based on their age, gender, genetic history, condition, or situation) of developing a (severe) disease. | |
| Targeted individuals (micro) | Targeted strategies and interventions designed for persons at extremely high risk or who already show (a)symptomatic or clinical ‘abnormalities.’ | |
| Type of integration | System integration (macro) | Coherent set of (informal and formal) political arrangements to facilitate professionals and organisations to deliver a comprehensive continuum of care for the benefit of the general population. |
| Organisational integration (meso) | Inter-organisational partnerships (e.g. agreements, contracting, strategic alliances, knowledge networks, mergers) based on collaborative accountability and shared governance mechanisms, to deliver a comprehensive continuum of care to targeted sub-groups at risk. | |
| Professional integration (meso) | Inter-professional partnerships based on a shared understanding of competences, roles, responsibilities and accountability to deliver a comprehensive continuum of care to targeted subgroups at risk. | |
| Clinical integration (micro) | Coordination of person-focused care for a complex need at stake in a single process across time, place and discipline. | |
| Enablers of integration | Functional integration (micro-macro) | Communication mechanisms and tools (i.e. financial, management and information systems) structured around the primary process of service delivery that provide optimal information as a feedback mechanism for decision support between organisations, professional groups and individuals. |
| Normative integration (micro-macro) | Mutually respected cultural frame of reference (i.e. shared mission, vision, values and behaviour) between organisations, professional groups and individuals to achieve shared goals towards the Triple Aim outcomes. | |