References
- 1Ezeh AC, Bongaarts J, Mberu B. Global population trends and policy options. The Lancet. 2012 Jul 14; 380(9837): 142–8. DOI: 10.1016/S0140-6736(12)60696-5
- 2Divo MJ, Martinez CH, Mannino DM. Ageing and the epidemiology of multimorbidity. Eur Respir J. 2014 Oct 1; 44(4): 1055–68. DOI: 10.1183/09031936.00059814
- 3Borgermans L, Marchal Y, Busetto L, Kalseth J, Kasteng F, Suija K, et al. How to improve integrated care for people with chronic conditions: Key findings from EU FP-7 Project INTEGRATE and beyond. Int J Integr Care. 2017 Jul 1; 17(4). DOI: 10.5334/ijic.3096
- 4Tinetti ME, Fried TR, Boyd CM. Designing health care for the most common chronic condition – Multimorbidity. JAMA – Journal of the American Medical Association. 2012; 307: 2493–4. DOI: 10.1001/jama.2012.5265
- 5Hornby-Turner YC, Peel NM, Hubbard RE. Health assets in older age: A systematic review. Vol. 7, BMJ Open. BMJ Publishing Group; 2017. DOI: 10.1136/bmjopen-2016-013226
- 6Barr VJ, Robinson S, Marin-Link B, Underhill L, Dotts A, Ravensdale D, et al. The expanded Chronic Care Model: an integration of concepts and strategies from population health promotion and the Chronic Care Model. Hosp Q. 2003; 7(1): 73–82. DOI: 10.12927/hcq.2003.16763
- 7Epping-Jordan JoAnne, World Health Organization.
Noncommunicable Disease and Mental Health Cluster . Innovative care for chronic conditions: building blocks for action: global report. Noncommunicable Diseases and Mental Health, World Health Organization; 2002. 98 p. - 8Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the Chronic Care Model in the new millennium. Health Aff. 2009 Jan; 28(1): 75–85. DOI: 10.1377/hlthaff.28.1.75
- 9Baxter S, Johnson M, Chambers D, Sutton A, Goyder E, Booth A. The effects of integrated care: a systematic review of UK and international evidence. BMC Health Serv Res. 2018 May 10; 18(1). DOI: 10.1186/s12913-018-3161-3
- 10Berntsen GKR, Dalbakk M, Hurley JS, Bergmo T, Solbakken B, Spansvoll L, et al. Person-centred, integrated and pro-active care for multi-morbid elderly with advanced care needs: A propensity score-matched controlled trial. BMC Health Serv Res. 2019 Oct 3; 19(1): 1–17. DOI: 10.1186/s12913-019-4397-2
- 11Rocks S, Berntson D, Gil-Salmerón A, Kadu M, Ehrenberg N, Stein V, et al. Cost and effects of integrated care: a systematic literature review and meta-analysis. European Journal of Health Economics. 2020 Nov 1; 21(8): 1211–21. DOI: 10.1007/s10198-020-01217-5
- 12World Health Organization. WHO global strategy on people-centred and integrated health services Interim Report [Internet]; 2015. Available from:
www.who.int . - 13de Batlle J, Massip M, Vargiu E, Nadal N, Fuentes A, Bravo MO, et al. Implementing mobile health-enabled integrated care for complex chronic patients: Intervention effectiveness and cost-effectiveness study. JMIR Mhealth Uhealth. 2021 Jan 1; 9(1). DOI: 10.2196/22135
- 14Rijken M, Hujala A, van Ginneken E, Melchiorre MG, Groenewegen P, Schellevis F. Managing multimorbidity: Profiles of integrated care approaches targeting people with multiple chronic conditions in Europe. Health Policy (New York). 2018 Jan 1; 122(1): 44–52. DOI: 10.1016/j.healthpol.2017.10.002
- 15Direcció General de Planificació en Salut. Pla de salut de Catalunya 2016–2020. 2016; Available from:
http://scientiasalut.gencat.cat/handle/11351/4040 . - 16Blay-Pueyo C, Cabezas-Peña C, Corney-León JC, González-Mestre A, Ledesma A, Martínez M, et al. El Programa de prevenció i atenció a la cronicitat de Catalunya 2011-2014. Scientia. 2016; Available from:
http://www.recercat.cat/handle/11351/1842 . - 17Generalitat de Catalunya.
Pla interdepartamental d’atenció i interacció social i sanitària (PIAISS) . Salut Integral Barcelona [Internet]. Diari Oficial de la Generalitat de Catalunya; 2014. Available from:https://salutintegralbcn.gencat.cat/ca/ambits/atencio-social-i-sanitaria/pla-interdepartamental-datencio-in-interaccio-social-i-sanitaria-piaiss . - 18Gavaldà-Espelta E, Del Mar Lleixà-Fortuño M, Baucells-Lluis J, Ferré-Ferraté M, Mora-López G, Tomàs-Navarro B, et al. Effectiveness of the integrated care model Salut+Social in patients with chronic conditions: A mixed methods study protocol. Medicine. 2020 May 1; 99(19):
e19994 . DOI: 10.1097/MD.0000000000019994 - 19Pequeno NPF, Pequeno NPF, Cabral NL de A, Marchioni DM, Lima SCVC, Lyra C de O. Quality of life assessment instruments for adults: a systematic review of population-based studies. Health Qual Life Outcomes. 2020 Jun 30; 18(1): 1–13. DOI: 10.1186/s12955-020-01347-7
- 20Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: The new Medical Research Council guidance. Int J Nurs Stud. 2013; 50(5): 587–92. DOI: 10.1136/bmj.a1655
- 21Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. BMJ (Online). 2014; 348(March): 1–12. DOI: 10.1136/bmj.g1687
- 22Diari Oficial de la Generalitat de Catalunya. LLEI 12/2007, d’11 d’octubre, de serveis socials. [Internet]; 2007. Available from:
https://dogc.gencat.cat/ca/document-del-dogc/?documentId=415692 . - 23Jefatura del Estado.
Ley 39/2006, de 14 de diciembre, de Promoción de la Autonomía Personal y Atención a las personas en situación de dependencia . [Internet]. Spain; Available from:https://www.boe.es/buscar/act.php?id=BOE-A-2006-21990 . - 24Badia Llach X, Monserrat S, Roset M, Herdman M. Feasibility, validity and test-retest reliability of scaling methods for health states: The visual analogue scale and the time trade-off. Quality of Life Research. 1999; 8(4): 303–10. DOI: 10.1023/A:1008952423122
- 25Herdman M, Badia X, Berra S. EuroQol-5D: a simple alternative for measuring health-related quality of life in primary care. Atencion primaria/Sociedad Española de Medicina de Familia y Comunitaria. 2001; 28(6): 425–30. DOI: 10.1016/S0212-6567(01)70406-4
- 26Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986; 24(1): 67–74. DOI: 10.1097/00005650-198601000-00007
- 27Val Jiménez A, Amorós Ballestero G, Martínez Visa P, Fernández Ferré ML, León Sanromà M. [Descriptive study of patient compliance in pharmacologic antihypertensive treatment and validation of the Morisky and Green test]. Aten Primaria. 1992 Oct 1; 10(5): 767–70. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/1472599 . - 28Mira JJ, Nuño-Solinís R, Guilabert-Mora M, Solas-Gaspar O, Fernández-Cano P, González-Mestre MA, et al. Development and Validation of an Instrument for Assessing Patient Experience of Chronic Illness Care. Int J Integr Care. 2016 Aug 31; 16(3). DOI: 10.5334/ijic.2443
- 29Bédard M, Molloy DW, Squire L, Dubois S, Lever JA, O’donnell M. The Zarit Burden Interview: a new short version and screening version. Gerontologist. 2001 Oct 1; 41(5): 652–7. DOI: 10.1093/geront/41.5.652
- 30Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist. 1980; 20(6): 649–55. DOI: 10.1093/geront/20.6.649
- 31Direcció General de Planificació en Salut. Departament de Salut. Generalitat de Catalunya. L’estat de salut, els comportaments relacionats amb la salut i l’ús de serveis sanitaris a Catalunya, 2020 Resum executiu dels principals resultats de l’ESCA del 2020 Direcció General de Planificació en Salut; 2021.
- 32Spain: Country Health Profile 2019 [Internet]. OECD; 2019 [cited 2022 Feb 21]. (State of Health in the EU). Available from:
https://www.oecd-ilibrary.org/social-issues-migration-health/spain-country-health-profile-2019_8f834636-en . - 33Hopman P, de Bruin SR, Forjaz MJ, Rodriguez-Blazquez C, Tonnara G, Lemmens LC, et al. Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review. Health Policy (New York). 2016 Jul 1; 120(7): 818–32. DOI: 10.1016/j.healthpol.2016.04.002
- 34Kelly L, Harlock J, Peters M, Fitzpatrick R, Crocker H. Measures for the integration of health and social care services for long-term health conditions: A systematic review of reviews. BMC Health Serv Res. 2020 Apr 26; 20(1): 1–11. DOI: 10.1186/s12913-020-05206-5
- 35Gavaldà-Espelta E, Lleixà-Fortuño MDM, Aguilar Martín C, Pozo M, Ferré-Ferraté M, Tomàs-Navarro B, et al. Integrated Care Model Salut+Social Assessment by Professionals, Informal Caregivers and Chronic or Social Dependent Patients: A Qualitative Study. Int J Environ Res Public Health. 2022 Nov 22; 19(23). DOI: 10.3390/ijerph192315467
- 36Flanagan S, Damery S, Combes G. The effectiveness of integrated care interventions in improving patient quality of life (QoL) for patients with chronic conditions. An overview of the systematic review evidence. Vol. 15, Health and Quality of Life Outcomes. BioMed Central Ltd.; 2017. DOI: 10.1186/s12955-017-0765-y
- 37WHO global strategy on people-centred and integrated health services: interim report [Internet]. [cited 2022 Feb 24]. Available from:
https://apps.who.int/iris/handle/10665/155002 . - 38Santaeugènia SJ, Contel JC, Vela E, Cleries M, Amil P, Melendo-Azuela EM, et al. Characteristics and service utilization by complex chronic and advanced chronic patients in catalonia: A retrospective seven-year cohort-based study of an implemented chronic care program. Int J Environ Res Public Health. 2021; 18(18): 1–20. DOI: 10.3390/ijerph18189473
- 39Borrell C, Muntaner C, Benach J, Artazcoz L. Social class and self-reported health status among men and women: What is the role of work organisation, household material standards and household labour? Soc Sci Med. 2004; 58(10): 1869–87. DOI: 10.1016/S0277-9536(03)00408-8
- 40Artazcoz L, Cortès I, Borrell C, Escribà-Agüir V, Cascant L. Gender and social class differences in the association between early retirement and health in Spain. Womens Health Issues. 2010 Nov; 20(6): 441–7. DOI: 10.1016/j.whi.2010.07.007
- 41Direcció General de l’Autonomia Personal i la Discapacitat. Avaluació de l’atenció integrada social i sanitària a l’entorn domiciliari. Barcelona; 2021.
- 42Departament de Treball AS i F. Registre unificat de dades dels ens locals; 2016.
