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Table 4 Integrated care services

From: Organizational interventions to implement improvements in patient care: a structured review of reviews

Author, number of studies Quality score Focus Main results
Badamgarav 2003
N = 11
7 Rheumatoid arthritis Improved functional status (AES 0.27 NS).
Ferguson 1998
N = 9
4 Case management in various patient populations Improved patient-centered outcomes (PSI 6/6 = 100%), improved clinical outcomes (PSI 2/2 = 100%), reduced health resource use PSI 2/7 = 29%).
Kwan 2001
N = 10
9 In-hospital pathways for stroke Fewer urinary tract infections (AOR 0.38, S). Fewer readmissions (AOR 0.11, S). More computer tomography brain scans (AOR 3.66, S). More carotid duplex studies (AOR 2.45, S). Reduced patient satisfaction (P = 0.02). Reduced quality of life (P = 0.005). No change in: mortality, dependency, or discharge destination.
McAllister 2001
N = 11
7 Disease management for heart failure in patients discharged from hospital Decreased hospital use (ARR 0.87), cost savings (PSI 7/8 = 88%). No change in: all-cause mortality.
McAllister 2001 (BMJ)
N = 12
7 Secondary prevention of coronary heart disease in outpatients Reduced hospital use (ARR 0.84 S), improved quality of life/functional status (PSI 5/8 = 63%), cost savings (PSI 2/3 = 67%). No change in: all-cause mortality, recurrent myocardial infarction.
Norris 2002
N = 42
5 Disease management and case management in diabetes Disease management: improved professional performance (SMD range 10–30%). Improved glycated hemoglobin (MNC -0.5% S).
Case management: improved glycated hemoglobin (MNC -0.53% S).
Ram 2001
N = 1
9 Asthma clinics in primary care Improved peak flow scores and other patient outcomes (PSI 1/1 = 100%).
Stroke Unit Trialist Collaboration 1997 N = 19 6 Organized inpatient care after stroke (rehabilitation, staff specialization, training and staff education) Reduced mortality (AOR 0.83, S). Reduced dependency or mortality (AOR 0.69, S). Reduced institutionalization (AOR 0.75, S). Reduced length of hospital stay (ARR 0.92 S).
Weingartenn 2002
N = 102
6 Disease management programs for patients with chronic illness: A. Provider education, feedback and reminders. B: Patient education, reminders and financial incentives. A: provider adherence to guidelines (AES range: 0.44 – 0.61), patient disease control (AES range: 0.17 – 0.35).
B: patient disease control (AES range: 0.24 – 0.40).