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综合照护的更新发展模式:系统评价与模式更新

The renewed Development Model for Integrated Care: a systematic review and model update.

作者信息

Minkman Mirella M N, Zonneveld Nick, Hulsebos Kirsten, van der Spoel Marloes, Ettema Roelof

机构信息

Tilburg University - TIAS, Warandelaan 2, TIAS Building, Tilburg, 5037 AB, The Netherlands.

Vilans, National Knowledge center for Care & Support, Utrecht, The Netherlands.

出版信息

BMC Health Serv Res. 2025 Mar 26;25(1):434. doi: 10.1186/s12913-025-12610-2.

Abstract

BACKGROUND

Organising integrated health services beyond domains in interorganizational networks, can be supported by conceptual models to overview the complexity. The Development Model for Integrated Care (DMIC) is a systematically developed generic model that has been applied to innovate and implement integrated care services in a large range of (international) healthcare settings. After a decade, it is important to incorporate new available literature in the model. Therefore, our aim was to update and further develop the DMIC by incorporating the current body of knowledge.

METHODS

A systematic literature review and subsequent stepwise systematic update of the DMIC.

RESULTS

The review of the literature resulted in 179 included studies and eventually 20 new elements for the development model, which could be positioned in the nine clusters. New elements address the importance of the social system and community of the client, proactive care during the life span, digital (care) services and ethical and value driven collaboration in interorganizational networks that cross domains. The added elements for integrated care build further on the nine thematic clusters and the model as a whole, expanded with new accents.

CONCLUSION

The renewed model emphasizes the connectedness of care within a larger eco-system approach and inter-organizational networks. The model captures current knowledge which can be supportive as a generic conceptual model to develop, implement or innovate integrated services towards health value in societies. Further, it can serve for healthcare services research purposes to reflect on an monitor developments in integrated care settings over time on multiple levels.

摘要

背景

在组织间网络中跨领域组织综合健康服务时,概念模型可辅助梳理复杂性。整合照护发展模型(DMIC)是一个经过系统开发的通用模型,已应用于众多(国际)医疗环境中综合照护服务的创新与实施。十年后,将新的现有文献纳入该模型很重要。因此,我们的目标是通过纳入当前的知识体系来更新并进一步发展DMIC。

方法

对DMIC进行系统的文献综述及后续逐步系统更新。

结果

文献综述纳入了179项研究,最终为发展模型确定了20个新要素,这些要素可归入九个类别。新要素涉及客户社会系统和社区的重要性、全生命周期的主动照护、数字(照护)服务以及跨领域组织间网络中基于伦理和价值驱动的协作。综合照护新增的要素在九个主题类别及整个模型的基础上进一步拓展,增添了新的重点内容。

结论

更新后的模型强调在更大的生态系统方法和组织间网络中照护的关联性。该模型涵盖了当前的知识,可作为一个通用概念模型,支持在社会中开发、实施或创新朝向健康价值的综合服务。此外,它可用于医疗服务研究,以多层次反思和监测综合照护环境随时间的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72ed/11938726/a9b866fff63c/12913_2025_12610_Fig1_HTML.jpg

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