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Outcomes of integrated chronic care interventions including workforce changes

Loraine Busetto, Katrin Ger Luijkx, Stefano Calciolari, Laura Guadaalupe Gonzalezx Ortiz, Hubertus Johannes Maria Vrijhoef


Background: Integrated care is seen as a promising approach to deal with the current mismatch between people’s increasing demand for complex, long-term and person-centred care and a traditional supply of acute, episodic and single-disease-focused care. Given the involvement of health professionals in all aspects of integrated care delivery, changes to the health workforce are seen as a key enabler of integrated health services delivery.

Objectives: The first aim of this study was to investigate the outcomes of integrated care interventions for people with chronic conditions that included workforce changes. The second aim was to develop preliminary insights into the relative benefits of measuring the outcomes of workforce changes that are part of integrated care interventions as opposed to measuring integrated care interventions that included workforce changes.

Method: Data were collected by means of an expert questionnaire and a literature review. While the expert questionnaire investigated the outcomes of the workforce changes that were part of an integrated care intervention, the literature review investigated the outcomes of integrated care interventions that included workforce changes.

Results: Overall, both approaches found positive outcomes, in particular for quality of care (including clinical patient outcomes and process measures), patient satisfaction and staff satisfaction. Outcomes were reported for the same categories in the studies as in the questionnaires. 

Conclusion: We recommend that health managers and policy makers invest in workforce changes and to (re-)consider strategies that may be detrimental to the health workforce and which could thereby adversely affect patient health and patient experiences of care.


Chronic conditions, health workforce, integrated care, literature review, person-centered healthcare, Quadruple Aim, quality of care, workforce changes

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