Table 1
Case selection criteria of innovative models.
| Original criteria | Adapted criteria | |
|---|---|---|
| 1. | Collaboration (horizontal and vertical) | Vertical integration with hospitals and/or GPs - Effective contact and communication; supported by standardised referral procedures, single contact points or shared assessment instruments - Clear distribution of responsibilities; based on formal agreements or strong informal relations - Mutual trust among providers; for example delegation of specialised medical tasks to intermediate care team |
| 2. | Care provision to geographically defined population | Intermediate care team provides care in municipality only; no blurring of geographical boundaries with collaboration with larger hospitals |
| 3. | Inclusion based on overall assessment of health and social care needs | Intermediate care teams flexible in terms of tasks performed and inclusion not disease specific |
| 4. | Care provision for older people | Exclusion of teams with primary or exclusive focus on patients with mental health problems |
Table 2
Case selection criteria of contexts of innovative models.
| Original criteria | Adapted criteria | |
|---|---|---|
| Organisational level | ||
| 1. | Organizational size | Size of municipality |
| - Population size | ||
| 2. | Resources | Municipal resources |
| - Expenditure on health and social care; both absolute and per capita | ||
| 3. | Geography | Proximity to hospitals and GPs - Distance to closest hospital - Average number of enrolled patients per GP Location of municipality - Urban or rural - Relevant region |
| Professional level | ||
| 4. | Prior co-operation among providers | Relative strength of existing co-operation; for example formed through earlier intersectoral projects |
| 5. | Existing multidisciplinary team work | Degree of existing inter-professional teamwork; such as strategic recruitment of specialised nurses, employment of practitioner consultant |
Table 3
Selection criteria of municipal intermediate care teams – innovative models.
| AARHUS | SLAGELSE | VARDE |
|---|---|---|
| Hospital-based model of integration | Institutionally supported GP-based model of integration | Informally supported GP-based model of integration |
| Strong integration with hospital geriatric team | Strong integration with GPs | Strong integration with GPs |
| Standardised referral procedures, single point of contact, shared assessment instruments Formal agreements on distribution of responsibility; relatively high mutual trust (core tasks) | Standardised referral procedures, single point of contact, shared assessment instruments No formal agreements, but strong informal relations supported by municipal GP; high mutual trust (extensive delegation of medical tasks) | Standardised referral procedures, single point of contact No formal agreements, informal relations informally supported over long period of time; high mutual trust (extensive delegation of medical tasks) |
| Care provision for people living in municipality | Care provision for people living in municipality | Care provision for people living in municipality |
| Focus on complex needs, may include more or less specialised health and social care services | Focus on acute care needs and complex health and social care needs (outside existing municipal health and social care system) | Focus on acute care needs and needs for specialised health care |
| Frail elders with comorbidity as primary target group | Elderly people with complex needs as main target group | Elderly people and people with comorbidity as principal target group |
Table 4
Selection criteria of municipal intermediate care teams – contexts of innovative models.
| Case selection criteria | AARHUS | SLAGELSE | VARDE | |
|---|---|---|---|---|
| Hospital-based model of integration | Institutionally supported GP-based model of integration | Informally supported GP-based model of integration | ||
| Organisational level | ||||
| 1. | Size of municipality | Second largest municipality in Denmark; population of 340 4211 | One of larger municipalities in Denmark; population of 78 9681 | One of smallest municipality in Denmark; population of 50 3011 |
| 2. | Municipal resources | 1 410 981 000 DKK2 | 398 750 000 DKK2 | 244 780 000 DKK2 |
| 3. | Proximity to hospitals and GPs | High for both hospital and GPs Largest hospital in Denmark located in municipality Average number of patient pr. GP less than 1,600; less than one third of GPs older than 60 | High for hospital, medium for GPs Smaller hospital located in municipality Average number of patient pr. GP between 1,600 and 1699; up to 39 per cent GPs older than 60 | Low for hospital, medium for GPs Nearest hospital located in 30–50 km radius Average number of patient pr. GP less than 1,600; more than one third of GPs older than 60; long distance in more rural areas as geographically large municipality |
| 4. | Location of municipality | Mainly urban areas Part of Central Denmark Region | Urban and rural areas Part of Region Sealand | Large rural areas Part of Southern Denmark Region |
| Professional level | ||||
| 5. | Prior co-operation among providers | Strong ties Many cross sectoral projects between municipal healthcare providers and geriatric hospital ward | Selected, fairly strong ties Well-functioning follow-up home visits between municipal healthcare providers and some GP practices | Individual, strong ties No specific programme for building ties, but do exist in relation to individual care trajectories |
| 6. | Existing multidisciplinary team work | Team of specialist nurses with 5+ years experience, nurses and nurse assistants | Team of specialist nurses with relevant experience, nurses and nurse assistants; municipal GP offers further liaising | Team of specialist nurses with relevant experience, nurses and nurse assistants |
[i] Notes:
1 Figures from 2017; Statistics Denmark, StatBank Denmark: FOLKA: FOLK1A: POPULATION AT THE FIRST DAY OF THE QUARTER BY REGION, SEX, AGE AND MARITAL STATUS. (http://www.statistikbanken.dk/statbank5a/SelectVarVal/Define.asp?MainTable=FOLK1A&PLanguage=1&PXSId=0&wsid=cftree).
2 Figures from 2017; Statistics Denmark, StatBank Denmark: REGK11: MUNICIPALITY ACCOUNTS (DKK 1,000) BY REGION, MAIN ACCOUNT, DRANST AND KIND. (http://www.statistikbanken.dk/10188).