Evaluation of a population-based integrated care model: A case study from the London Borough of Hillington

Abstract

Integrated care models (ICMs) are becoming more popular in addressing healthcare concerns because they improve coordination and continuity of care, promote self-management and preventative treatment, and place a premium on personalization of care. These models bring together various healthcare providers to collaborate in a coordinated manner, reducing fragmentation in traditional healthcare delivery models and leading to improved health outcomes and lower healthcare costs. ICMs put the patient at the centre of care, increasing satisfaction and quality of life. Despite earlier research and synthesis attempts to evaluate ICMs, evidence on how successfully the new integrated care models, including those with population-based approaches, may achieve their intended benefits remains limited, especially in contexts like England. This thesis aimed to add to our understanding of the effectiveness and evaluation of ICMs by taking the London borough of Hillingdon, in England, as a case study. The thesis used sophisticated statistical analyses, including interrupted time series, to understand and evaluate effectiveness. The evaluation of the population-based ICM in Hillingdon revealed promising results in terms of reducing non-elective hospital admissions, A&E visits, and hospital stay length. The study also found predictors of Hillingdon hospital activity, such as GP practices, LTCs, and demographics. These predictors can help in stratifying populations based on their risk of requiring hospitalisation, lowering expenses, and putting less strain on health-care systems. The study, however, had limitations, and the findings should be regarded with caution. Further research is required to assess the impact of ICMs on other outcomes, such as condition-related knowledge, and to undertake a process evaluation of the facilitators and barriers to effectiveness and implementation. Despite its limitations, this study is an invaluable resource for health professionals, commissioners, and policymakers in England looking for the most recent evidence synthesis relevant to their context.