Table 1. Study characteristics and methodological quality of studies.
Author, Year, Country | Aim | Sample | Methods | Theoretical Perspective | Quality score (CASP) |
---|---|---|---|---|---|
Boudioni et al 2015 UK [26] |
To explore service users’ and family carers’ perspectives of an integrated care service in London | 5 service users with complex health conditions and 5 carers | Video stories analysed between researchers and service users, as part of an experience-based co-design evaluation | Principles of visual sociology | 8.5 |
Hu (2014) UK [27] |
To examine service users’ views of the impact of an integrated care service in England | 100 older care service users surveyed, then 27 older adults aged ≥ 65 years with complex care needs selected | Mixed methods: survey then face-to-face interviews with sub-sample of participants | Not specified | 5.5 |
Ballie et al (2014) UK [28] |
To investigate service users’ and providers’ perspectives of care transitions in a vertically organised integrated healthcare system | 17 providers, including range of acute (N = 8) and community care providers (N = 9) and 4 older adults with frailty aged ≥ 70 years | Qualitative case study using face-to-face interviews with key staff and patients, and focus groups with ward staff | Ritchie & Spencer’s (1994) five-stage framework analysis | 8 |
Bone et al (2016) UK [29] |
To explore views of service users and other key stakeholders to inform development of a short-term community-based integrated palliative and supportive care intervention for OPF | 63 participants (healthcare providers, commissioners, voluntary sector representatives, carers, researchers) took part in stakeholder consultations; 42 participants (providers, carers, researchers) took part in survey; 8 frail older people aged ≥ 75 years and 9 carers | Expert stakeholder consultations and follow-up consensus surveys with providers, carers and researchers; focus groups with service users and carers | Not specified | 10 |
Sheaff et al (2009) UK [30] |
To elicit service users’, carers’ and providers’ perspectives on the impacts of different case management systems across 9 primary care trusts in England | Range of providers working in acute, primary, secondary and community care (N = 70); 72 older people aged ≥ 65 years with range of long term conditions, and 52 informal carers | Multiple case study evaluation design; face-to-face interviews, observations of meetings and analysis of key documents | Not specified | 7 |
de Stampa et al (2009) Canada [31] |
To examine incentives and barriers among GPs to take part in integrated health services networks (IHSNs) to enable integrated care for frail older adults in Montreal | 61 GPs enrolled in an integrated care system for older adults, of which a random sample of 22 GPs actively or non-actively participating in IHSNs recruited | Initial mail survey, then subsample of GPs took part in face-to-face interviews | Not specified | 7.5 |
Heckman et al (2013) Canada [32] |
To identify providers’, service users’ and carers’ perspectives on improving integration care for frail seniors in Ontario | 186 providers in primary, secondary and community care and 29 service users and carers | Secondary analysis of 20 focus group discussions | Not specified | 7 |
Lafortune et al (2015) Canada [33] |
To explore older adults’, carers’ and providers’ views on improving primary healthcare community services for older adults with long term conditions in an area of Ontario | Range of healthcare providers (N = 20); 28 service users aged ≥ 65 with experience of one or more services (e.g. chronic disease management, end of life care) and their informal carers | Focus groups with care providers (N = 4) and service users and carers (N = 3), and individual interview with informal carer | Not specified | 7.5 |
McAiney et al (2017) Canada [34] |
To examine service users’, carers’ and providers’ perceptions of the impact of an intensive geriatric service worker (IGSW) service in South Ontario | 19 providers (IGSW program lead, case manager, nurses, geriatrician); 49 service users aged ≥ 65 with age-related conditions; 25 informal carers | Mixed methods design; initial patient satisfaction survey; purposive sample of all stakeholders took part in telephone interviews (N = 93) | Not specified | 6.5 |
Spoorenberg et al (2015) The Netherlands [35] |
To examine service users’ views of a community-based integrated care intervention based on the Chronic Care Model | 23 older adults aged ≥ 75 years, mostly with frailty or complex needs, sampled from a trial | Face-to-face interviews 8–10 months after starting the intervention | Grounded theory approach | 9 |
Janssen et al (2015) The Netherlands [36] |
To examine providers’ views of organisational features facilitating implementation of community integrated care for older adults | 12 providers (nurses, case managers, GP, nursing home manager, homecare worker, geriatrician) | Qualitative case study: face-to-face interviews, observations of team meetings, then focus groups to discuss findings | Nomological network of organisational empowerment (Peterson & Zimmerman 2004) | 8.5 |
Metzelthin et al (2013) The Netherlands [37] |
To examine service users’ and providers’ experiences of an interdisciplinary primary care model for OPF, and perceived barriers and enablers to implementation in south Holland | 45 care providers (nurses, GPs, allied health providers); 194 service users aged ≥ 70 years scoring ≥ 5 on the Groningen Frailty Indicator. Participants recruited from 6 GP practices | Mixed methods process evaluation: quantitative log books and evaluation forms for all service users; interviews with subsample of 13 participants; focus groups (N = 4) and interviews (N = 12) with providers | Baranowski and Stables’ (2000) process evaluation model | 7.5 |
Hjelm et al (2015) Sweden [38] |
To explore service users’ experiences of case managers | 13 older adults aged ≥ 75 years with ≥ 3 long term conditions who received the case management intervention | Focused ethnographic approach including observations of case manager practices and face-to-face interviews | Roper & Shapira’s (2000) framework for ethnographic analysis | 8 |
Dunér et al (2011) Sweden [39] |
To examine providers’ views of implementing a new continuum of care model for frail older people | 26 providers (upper managers, nurses, allied health providers, social workers, case managers) | Repeat face-to-face interviews, as part of a trial of the intervention | Lipsky’s (1980) theory of street-level bureaucracy | 6 |
Freij et al (2011) USA [40] |
To examine older adults’ experiences of care coordination services in the New York City area | 48 older adults aged ≥ 55 years (majority ≥ 75 years) from multi-ethnic backgrounds, targeting older adults with frailty | Face-to-face interviews (N = 25) and focus groups (N = 6) | Grounded theory approach | 7.5 |
Keefe et al (2009) USA [41] |
To examine primary care physicians’ and nurses’ views of implementing integrated care for frail older people, and the benefits of social worker integration in primary care teams | 25 providers (13 physicians, 11 nurses, 1 nurse practitioner) working in primary care | Focus groups (N = 3) conducted at 2 primary care clinics | Grounded theory approach | 5.5 |
Busetto et al (2017) Germany [42] |
To explore providers’ views of implementing an integrated care model in a German hospital, as part of a comparative European project | 15 MDT care providers (physicians, nurses, allied health providers, psychologists, social workers) | Face-to-face interviews | Wagner's (1998) Chronic Care Model, Grol and Wensing's (2004) Implementation Model, Realist evaluation approach | 8.5 |
de Stampa et al (2013) Canada/France [43] | To understand the clinical collaboration process between primary care physicians (PCPs), case managers and geriatricians in two integrated care systems for frail older adults | 46 care providers (35 PCPs, 7 case managers, 4 geriatricians) | Face-to-face interviews | Grounded theory approach | 7.5 |