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.

Additional Metadata
Keywords Chronic care, Comorbidity, Conceptual, Frail elderly, Framework, Integrated care, Model, Multi-morbidity
Persistent URL dx.doi.org/10.1016/j.healthpol.2017.06.002, hdl.handle.net/1765/100734
Journal Health Policy
Citation
Leijten, F.R.M, Struckmann, V. (Verena), van Ginneken, E. (Ewout), Czypionka, T. (Thomas), Kraus, M. (Markus), Reiss, M. (Miriam), … Mölken, M.R.V. (Maureen Rutten-van). (2017). The SELFIE framework for integrated care for multi-morbidity: Development and description. Health Policy. doi:10.1016/j.healthpol.2017.06.002