References
- United Nations DPD. Word population Prospects: The 2017 Revision, custom data acquired via website. 2017. [cited 2017 October 4]. Available from:
https://population.un.org/wpp/ . - Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev, 2011; 10: 430–439. DOI: 10.1016/j.arr.2011.03.003
- Luppi F, Franco F, Beghe B, Fabbri LM. Treatment of chronic obstructive pulmonary disease and its comorbidities. Proc Am Thorac Soc, 2008; 5: 848–856. DOI: 10.1513/pats.200809-101TH
- American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians. J Am Geriatr Soc, 2012; 60: E1–E25. DOI: 10.1111/j.1532-5415.2012.04188.x
- Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet, 2012; 380: 37–43. DOI: 10.1016/S0140-6736(12)60240-2
- McPhail SM. Multimorbidity in chronic disease: impact on health care resources and costs. Risk Manag Healthc Policy, 2016; 9: 143–156. DOI: 10.2147/RMHP.S97248
- Ham C. The ten characteristics of the high-performing chronic care system. Health Econ Policy Law, 2010; 5: 71–90. DOI: 10.1017/S1744133109990120
- World Health Organization.
WHO Framework on Integrated People-Centred Health Services . 2016. Geneva: WHO. Available from:http://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_39-en.pdf?ua=1 . - Loader BD, Hardey M, Keeble L. Health informatics for older people: a review of ICT facilitated integrated care for older people. International Journal of Social Welfare, 2008; 17: 46–53. DOI: 10.1111/j.1468-2397.2007.00489.x
- Kovac M. E-Health Demystified: An E-Government Showcase. IEEE Computer, 2014; 34–42. DOI: 10.1109/MC.2014.282
- American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Patient-centered care for older adults with multiple chronic conditions: a stepwise approach from the American Geriatrics Society. J Am Geriatr Soc, 2012; 60: 1957–1968. DOI: 10.1111/j.1532-5415.2012.04187.x
- Health Service Delivery Programme Division of Health Systems ans Public Health.
Transforming health services delivery towards people-centred health systems . 2014. Copenhagen: WHO Regional Office for Europe. Available from:http://www.euro.who.int/__data/assets/pdf_file/0016/260710/Transforming-health-services-delivery-towards-people-centred-health-systems.pdf . - Raleigh V, Bardsley M, Smith P, Wistow G, Wittenberg R, Erens B, et al. Integrated care and support Pioneers: Indicators for measuring the quality of integrated care. Final report, 2014. Policy innovation research unit (PIRU). Available from:
https://piru.lshtm.ac.uk/assets/files/IC_and_support_Pioneers-Indicators.pdf . - Ouwens M, Wollersheim H, Hermens R, Hulscher M, Grol R. Integrated care programmes for chronically ill patients: a review of systematic reviews. Int J Qual Health Care, 2005; 17: 141–146. DOI: 10.1093/intqhc/mzi016
- Singh D. Surrey and Sussex Primary Care Trust Alliance: Transforming chronic care: a systematic review of the evidence. Evidence-based Cardiovascular Medicine, 2005; 9: 91–94. DOI: 10.1016/j.ebcm.2005.03.011
- de Bruin SR, Versnel N, Lemmens LC, Molema CC, Schellevis FG, Nijpels G, et al. Comprehensive care programs for patients with multiple chronic conditions: a systematic literature review. Health Policy, 2012; 107: 108–145. DOI: 10.1016/j.healthpol.2012.06.006
- Hoogendijk EO. How effective is integrated care for community-dwelling frail older people? The case of the Netherlands. Age Ageing, 2016; 45: 585–588. DOI: 10.1093/ageing/afw081
- Mercer SW, Smith SM, Wyke S, O’Dowd T, Watt GC. Multimorbidity in primary care: developing the research agenda. Fam Pract, 2009; 26: 79–80. DOI: 10.1093/fampra/cmp020
- Exworthy M, Powell M, Glasby J. The governance of integrated health and social care in England since 2010: great expectations not met once again? Health Policy, 2017; 121: 1124–1130. DOI: 10.1016/j.healthpol.2017.07.009
- Fullaondo A, Ponce S, Mora J, de Manuel-Keenoy E. Delivering integrated care to frail patients through ICT. D3.1 CareWell Organisational and service process models. (Deliverable 3.1), CareWell Project 2014. Available from:
http://carewell-project.eu/fileadmin/carewell/deliverables/d3.1_carewell_organisational_models_and_pathways.pdf . - Yesavage JA, Sheikh JI. Geriatric Depression Scale (GDS). Clinical Gerontologist, 1986; 5: 165–173. DOI: 10.1300/J018v05n01_09
- Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J, 1965; 14: 61–65. DOI: 10.1037/t02366-000
- Collin C, Wade DT, Davies S, Horne, V: The Barthel ADL Index: a reliability study. Int Disabil Stud, 1988; 10: 61–63. DOI: 10.3109/09638288809164103
- King J, Gibbons E, Graham C, Walsh J.
Developing measures of people’s self-reported experiences of integrated care ; 2013. Picker Institute Europe. Available from:https://www.picker.org/wp-content/uploads/2014/10/Developing-measures-of-IC-report_final_SMALL.pdf . - European Commission. European Innovation Partnership on Active and Healthy Ageing; 2017. [webpage on the internet]. [cited 2017 October 4; updated 2019 May 15]. Available from:
https://ec.europa.eu/eip/ageing/home_en . - Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the Chronic Care Model in the new millennium. Health Aff (Millwood), 2009; 28: 75–85. DOI: 10.1377/hlthaff.28.1.75
- Singh D. Transforming Chronic Care. 2005. [cited 2017 October 6]. Available from:
https://www.cfhi-fcass.ca/sf-docs/default-source/on-call/2014-10-14-singh-transformingchroniccare-2005.pdf?sfvrsn=115ada44_2 . - van der Heide I, Snoeijs S, Quattrini S, Struckmann V, Hujala A, Schellevis F, et al. Patient-centeredness of integrated care programs for people with multimorbidity. Results from the European ICARE4EU project. Health Policy, 2018; 122: 36–43. DOI: 10.1016/j.healthpol.2017.10.005
- OECD.
Health reform: Meeting the challenge of ageing and multiple morbidities ; 2011. OECD Publishing. Available from:http://www.oecd.org/health/health-systems/health-reform-9789264122314-en.htm . - World Health Organization. World report on ageing and health; 2015. Available from:
https://www.who.int/ageing/events/world-report-2015-launch/en/ . - Lewis L, Goodwin N. Guideline for Implementing Integrated Care in Policy and Practice. The Journey to Deploying Scalable Integrated Healthcare Services. An evidence review with key learning from the CareWell project (Deliverable 8.6), CareWell Project 2017. 9-2-2018. Available from:
http://carewell-project.eu/fileadmin/carewell/guidelines/the_carewell_guidelines_for_implementing_integrated_care_in_policy_and_practice.pdf . - Goodwin N. Tomorrow’s World: Is Digital Health the Disruptive Innovation that will Drive the Adoption of Integrated Care Systems? International Journal of Integrated Care, 2018; 18(4): 14. DOI: 10.5334/ijic.4638
- Soto-Gordoa M, Arrospide A, Merino HM, Mora AJ, Fullaondo ZA, Larranaga I, et al. Incorporating Budget Impact Analysis in the Implementation of Complex Interventions: A Case of an Integrated Intervention for Multimorbid Patients within the CareWell Study. Value Health, 2017; 20: 100–106. DOI: 10.1016/j.jval.2016.08.002
- Jon Matthew J, Pujol L. Impact of EU-Funded Research and Innovation on ICT for Active and Health Ageing. The Top 25 Most Influential Projects. 21-03-2018. Available from:
https://ec.europa.eu/digital-single-market/en/news/top-25-influential-ict-active-and-healthy-ageing-projects . - Sackett DL, Strauss SE, Richardson WS, Rosenberg W, Haynes RB.
Evidence-based medicine: how to practice and teache EBM . Edinburgh: Churchill Livingstone: 2000. - Goodwin, N. How important is information and communication technology in enabling interprofessional collaboration? Journal of Health Services Research and Policy, 2017; 22(4): 202–203. DOI: 10.1177/1355819617727030
- Suter E, Oelke ND, Adair C, Armitage GD. Ten key principles for successful health systems integration. Healthcare Quarterly, 2009; 13(Spec No): 16–23. DOI: 10.12927/hcq.2009.21092