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The SELFIE framework for integrated care for multi-morbidity: development and description
Leijten, Fenna R.M.; Struckmann, Verena; van Ginneken, Ewout; Czypionka, Thomas; Kraus, Markus; Reiss, Miriam; Tsiachristas, Apostolos; Boland, Melinde; de Bont, Antoinette; Bal, Roland; Busse, Reinhard; Rutten-van Mölken, Maureen
Background
The rise of multi-morbidity constitutes a serious challenge in health and social care organisation that requires a shift from disease- towards person-centred integrated care. The aim of the current study was to develop a conceptual framework that can aid the development, implementation, description, and evaluation of integrated care programmes for multi-morbidity.
Methods
A scoping review and expert discussions were used to identify and structure concepts for integrated care for multi-morbidity. A search of scientific and grey literature was conducted.
Discussion
meetings were organised within the SELFIE research project with representatives of five stakeholder groups (5Ps): patients, partners, professionals, payers, and policy makers.
Results
In the scientific literature 11,641 publications were identified, 92 were included for data extraction. A draft framework was constructed that was adapted after discussion with SELFIE partners from 8 EU countries and 5P representatives. The core of the framework is the holistic understanding of the person with multi-morbidity in his or her environment. Around the core, concepts were grouped into adapted WHO components of health systems: service delivery, leadership & governance, workforce, financing, technologies & medical products, and information & research. Within each component micro, meso, and macro levels are distinguished.
Conclusion
The framework structures relevant concepts in integrated care for multi-morbidity and can be applied by different stakeholders to guide development, implementation, description, and evaluation.
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