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Integrated care programs can reduce hospital admissions, improve adherence to treatment guidelines and improve patient quality of life

Martínez-González NA, Berchtold P, Ullman K, Busato A, Egger M. International Journal for Quality in Health Care. October 2014;26(5):561-570.

Review question

Do integrated care programs for adults with chronic conditions lead to reduced use of healthcare resources, greater adherence to treatments, improved patient quality of life, and cost-savings?

Background

Integrated care programs make use of technology and change organizational structure to improve coordination between healthcare professionals.

Enhancing healthcare collaboration is a promising means of improving quality of life for patients with chronic diseases and allowing for more efficient use healthcare resources.

Several systematic reviews have investigated the effectiveness of integrated care for patients with chronic disease, but they are outdated and of questionable quality. 

How the review was done

A number of electronic databases were searched for reviews published between 1946 and 2012, and those that focused on the effects of integrated care programs in adult patients with chronic non-communicable diseases were included in an overview of reviews.  

Of the 3610 reviews identified, 27 were deemed eligible and included in the overview.

This overview was funded by the Swiss Federal Office of Public Health.

What the researchers found

Integrated care was consistently shown to reduce hospital admission and re-admission, improve adherence to treatment guidelines, and improve quality of life among adults with chronic disease.

There is little evidence to suggest that integrated care results in a reduction of direct or indirect costs.

The quality of included studies varied, and few looked at all components of integrated care systems.  

Conclusion

Integrated care programs were found to reduce demand for healthcare resources and improve adherence to treatment guidelines, however few included studies showed a reduction in costs. More high-quality evidence is needed to confirm which components or interventions should be prioritized in integrated care programs to maximize their benefit.