Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton ON, L8S 4L8 Canada.
Int J Integr Care. 2012 Sep 18;12:e137. doi: 10.5334/ijic.835. Print 2012 Jul-Sep.
Integration involves the coordination of services provided by autonomous agencies and improves the organization and delivery of multiple services for target patients. Current measures generally do not distinguish between agencies' perception and expectation. We propose a method for quantifying the agencies' service integration. Using the data from the Children's Treatment Network (CTN), we aimed to measure the degree of integration for the CTN agencies in York and Simcoe.
We quantified the integration by the agreement between perceived and expected levels of involvement and calculated four scores from different perspectives for each agency. We used the average score to measure the global network integration and examined the sensitivity of the global score.
Most agencies' integration scores were <65%. As measured by the agreement between every other agency's perception and expectation, the overall integration of CTN in Simcoe and York was 44% (95% CI: 39%-49%) and 52% (95% CI: 48%-56%), respectively. The sensitivity analysis showed that the global scores were robust.
Our method extends existing measures of integration and possesses a good extent of validity. We can also apply the method in monitoring improvement and linking integration with other outcomes.
整合涉及协调自主机构提供的服务,并改善目标患者的多项服务的组织和交付。目前的措施通常无法区分机构的感知和期望。我们提出了一种量化机构服务整合的方法。使用来自儿童治疗网络(CTN)的数据,我们旨在衡量约克和西蒙克的 CTN 机构的整合程度。
我们通过感知和期望参与度之间的一致性来量化整合,并为每个机构从不同角度计算了四个分数。我们使用平均分数来衡量全局网络整合,并检查全局分数的敏感性。
大多数机构的整合分数<65%。按照每个其他机构的感知和期望之间的一致性来衡量,Simcoe 和 York 的 CTN 整体整合度分别为 44%(95%CI:39%-49%)和 52%(95%CI:48%-56%)。敏感性分析表明,全局分数是稳健的。
我们的方法扩展了现有整合措施,并具有良好的有效性。我们还可以将该方法应用于监测改进,并将整合与其他结果联系起来。