Value-based integrated (renal) care: setting a development agenda for research and implementation strategies

Area of Science:

• Healthcare Management
• Health Services Research
• Integrated Care Models

Background:

• Integrated care services are crucial for enhancing the Triple Aim in chronic kidney disease (CKD) management.
• Limited scholarly guidance exists on developing, implementing, and evaluating value-based integrated renal care.
• This study addresses the need for a structured approach to integrated renal care.

Purpose of the Study:

• To develop a framework for identifying strategies and outcomes in the implementation of value-based integrated renal care.
• To synthesize existing evidence on integrated renal care strategies and outcomes.
• To establish a developmental agenda for integrated renal care practice and research.

Main Methods:

• United theoretical foundations of the Rainbow Model of Integrated Care and the Triple Aim into an overarching framework.
• Conducted a rapid review of published research on integrated renal care (2000-2015) using multiple databases.
• Developed a coding schema based on the framework to synthesize findings from reviewed articles.

Main Results:

• The developed framework includes domains for type of integration, enablers, and outcomes (experience of care, population health, costs).
• Literature synthesis revealed a focus on micro-level clinical processes and physical outcomes in integrated renal care implementation.
• Limited emphasis was found on meso-organizational and macro-system integration, patient-reported outcomes, and economic outcomes.

Conclusions:

• Future research should explore integrated care strategies that improve health outcomes and patient experience while reducing costs.
• The study's framework and synthesis provide a foundation for advancing integrated renal care practice and research.
• Further work is planned to develop a specific implementation model for value-based integrated renal services.