SynthesisBMJ open2016
Does integrated care reduce hospital activity for patients with chronic diseases? An umbrella review of systematic reviews.
Synthesis in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07587073 (A Pragmatic Cluster-Randomized Evaluation of Enhanced Care Management With Community Supports, Transitional Care, and Residential Care Coordination for High-Risk Medi-Cal Members Under CalAIM in California), which is not on this map. Cited by 89 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Pragmatic Cluster-Randomized Evaluation of Enhanced Care Management With Community Supports, Transitional Care, and Residential Care Coordination for High-Risk Medi-Cal Members Under CalAIM in California
Who cites it
89 citing papers in PubMed, 13 syntheses or guidelines pooled it.
- Effectiveness of behaviour change techniques in lifestyle interventions for non-communicable diseases: an umbrella review.BMC public health · 2024Pooled it
- Person-centred integrated care for people living with Parkinson's, Huntington's and Multiple Sclerosis: A systematic review.Health expectations : an international journal of public participation in health care and health policy · 2024Pooled it
- Pooled it
- [Cost-Effectiveness of Case and Care Management in Older Populations in Germany: a Systematic Literature Review].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2023Pooled it
- Multicomponent integrated care for patients with chronic heart failure: systematic review and meta-analysis.ESC heart failure · 2023Pooled it
- Effectiveness of the chronic care model for adults with type 2 diabetes in primary care: a systematic review and meta-analysis.Systematic reviews · 2022Pooled it
- The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews.BMC public health · 2021Pooled it
- Cost and effects of integrated care: a systematic literature review and meta-analysis.The European journal of health economics : HEPAC : health economics in prevention and care · 2020Pooled it
- Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts.The Milbank quarterly · 2020Pooled it
- Measures for the integration of health and social care services for long-term health conditions: a systematic review of reviews.BMC health services research · 2020Pooled it
- Pooled it
- The effectiveness of integrated care interventions in improving patient quality of life (QoL) for patients with chronic conditions. An overview of the systematic review evidence.Health and quality of life outcomes · 2017Pooled it
- Delivery arrangements for health systems in low-income countries: an overview of systematic reviews.The Cochrane database of systematic reviews · 2017Pooled it
- Latinos understanding the need for adherence in diabetes (LUNA-D): a randomized controlled trial of an integrated team-based care intervention among Latinos with diabetes.Translational behavioral medicine · 2021Trial
- Implementing mHealth-Enabled Integrated Care for Complex Chronic Patients With Osteoarthritis Undergoing Primary Hip or Knee Arthroplasty: Prospective, Two-Arm, Parallel Trial.Journal of medical Internet research · 2021Trial
- Healthcare costs of managing MAFLD are mostly driven by hospitalisation and advanced fibrosis: cost analysis from a tertiary-care, multidisciplinary MAFLD clinic.Internal medicine journal · 2026Article
- Article
- Co-Designing Local Collaboration Between Social Services, Primary Healthcare, and the Third Sector-A Realist Process Evaluation.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Bridging organizational boundaries in complex care pathways: lessons from a Lean and Safety Management approach.BMC health services research · 2026Article
- Impact of integrated care models on inpatient costs and health services efficiency: evidence from a difference-in-differences analysis in China.Health policy and planning · 2026Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
objectiveTo summarise the evidence regarding the effectiveness of integrated care interventions in reducing hospital activity.
designUmbrella review of systematic reviews and meta-analyses.
settingInterventions must have delivered care crossing the boundary between at least two health and/or social care settings.
participantsAdult patients with one or more chronic diseases. DATA SOURCES: MEDLINE, Embase, ASSIA, PsycINFO, HMIC, CINAHL, Cochrane Library (HTA database, DARE, Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP, HEED, manual screening of references. OUTCOME MEASURES: Any measure of hospital admission or readmission, length of stay (LoS), accident and emergency use, healthcare costs.
results50 reviews were included. Interventions focused on case management (n=8), chronic care model (CCM) (n=9), discharge management (n=15), complex interventions (n=3), multidisciplinary teams (MDT) (n=10) and self-management (n=5). 29 reviews reported statistically significant improvements in at least one outcome. 11/21 reviews reported significantly reduced emergency admissions (15-50%); 11/24 showed significant reductions in all-cause (10-30%) or condition-specific (15-50%) readmissions; 9/16 reported LoS reductions of 1-7 days and 4/9 showed significantly lower A&E use (30-40%). 10/25 reviews reported significant cost reductions but provided little robust evidence. Effective interventions included discharge management with postdischarge support, MDT care with teams that include condition-specific expertise, specialist nurses and/or pharmacists and self-management as an adjunct to broader interventions. Interventions were most effective when targeting single conditions such as heart failure, and when care was provided in patients' homes.
conclusionsAlthough all outcomes showed some significant reductions, and a number of potentially effective interventions were found, interventions rarely demonstrated unequivocally positive effects. Despite the centrality of integrated care to current policy, questions remain about whether the magnitude of potentially achievable gains is enough to satisfy national targets for reductions in hospital activity. TRIAL REGISTRATION NUMBER: CRD42015016458.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.