SynthesisHealth & social care in the community2019
The (cost-)effectiveness of preventive, integrated care for community-dwelling frail older people: A systematic review.
Synthesis in Health & social care in the community, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05302310 (INSPIRE), which is not on this map. Cited by 53 papers, 5 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.
INSPIRE: Feasibility of a Community-based Integrated Care Model for Older Adults Living at Home
Who cites it
53 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Challenges to Systems of Long-Term Care: Mapping of the Central Concepts from an Umbrella Review.International journal of environmental research and public health · 2023Pooled it
- Effectiveness of information and communication technology-based integrated care for older adults: a systematic review and meta-analysis.Frontiers in public health · 2023Pooled 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
- The (cost-)effectiveness of preventive, integrated care for community-dwelling frail older people: A systematic review.Health & social care in the community · 2019Pooled it
- Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management.The journal of nutrition, health & aging · 2019Guideline
- Health Care Use of Frail Older People: Follow-Up Outcome Evaluation of an Intensive Primary Care Programme at 24 and 36 Months.Journal of the American Geriatrics Society · 2026Article
- Physical, Psychological, Cognitive and Social Frailty Domains in Community-Dwelling Adults Aged 45-85: a Cross-sectional Analysis of the Canadian Longitudinal Study on Aging (CLSA).Canadian geriatrics journal : CGJ · 2025Article
- Community-Based Health-Social Partnership Programme (C-HSPP) for enhancing self-care management among older adults: protocol for a hybrid effectiveness-implementation trial.BMC public health · 2025Article
- A Novel Integrated Geriatric Services Hub for Frailty Identification and Comprehensive Management of Community-Dwelling Older Adults in Singapore: Impact on Health Service Utilization.Journal of the American Geriatrics Society · 2025Article
- Does Allostatic Load in 50-89-Year-Olds Predict the Development of Frailty? Evidence From a National Longitudinal Study Over 12 Years.Stress and health : journal of the International Society for the Investigation of Stress · 2025Article
- '"Health" Is Just One Piece in the Puzzle of Wellbeing': Shifting From Preventing Health Deterioration to Improving Wellbeing in a Participatory Action Research Project With Care-Experienced Older People.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Integrated care for older people improved intrinsic capacity in elderly patients: a case control study.BMC geriatrics · 2024Article
- The valuation of older adult homecare services under a joint medical-social budgetary perspective.Frontiers in public health · 2024Article
- The development of an integrated neighborhood approach for health promotion and prevention: a qualitative exploration of stakeholders' views.Health research policy and systems · 2023Article
- An Integrated Patient-Centred Medical Home (PCMH) Care Model Reduces Prospective Healthcare Utilisation for Community-Dwelling Older Adults with Complex Needs: A Matched Observational Study in Singapore.International journal of environmental research and public health · 2023Observational
- Case management for integrated care of older people with frailty in community settings.The Cochrane database of systematic reviews · 2023Review
- Impact of MidMed, a general practitioner-led modified comprehensive geriatric assessment for patients with frailty.Age and ageing · 2023Article
- Article
- Frailty in older people: Rehabilitation Treatment Research Examining Separate Settings (FORTRESS): protocol for a hybrid type II stepped wedge, cluster, randomised trial.BMC geriatrics · 2022Article
- Home care for patients with dirty homes: a qualitative study of the problems experienced by nurses and possible solutions.BMC health services research · 2022Article
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
No grant is acknowledged in the PubMed record.
Abstract
Integrated care is increasingly promoted as an effective and cost-effective way to organise care for community-dwelling frail older people with complex problems but the question remains whether high expectations are justified. Our study aims to systematically review the empirical evidence for the effectiveness and cost-effectiveness of preventive, integrated care for community-dwelling frail older people and close attention is paid to the elements and levels of integration of the interventions. We searched nine databases for eligible studies until May 2016 with a comparison group and reporting at least one outcome regarding effectiveness or cost-effectiveness. We identified 2,998 unique records and, after exclusions, selected 46 studies on 29 interventions. We assessed the quality of the included studies with the Effective Practice and Organization of Care risk-of-bias tool. The interventions were described following Rainbow Model of Integrated Care framework by Valentijn. Our systematic review reveals that the majority of the reported outcomes in the studies on preventive, integrated care show no effects. In terms of health outcomes, effectiveness is demonstrated most often for seldom-reported outcomes such as well-being. Outcomes regarding informal caregivers and professionals are rarely considered and negligible. Most promising are the care process outcomes that did improve for preventive, integrated care interventions as compared to usual care. Healthcare utilisation was the most reported outcome but we found mixed results. Evidence for cost-effectiveness is limited. High expectations should be tempered given this limited and fragmented evidence for the effectiveness and cost-effectiveness of preventive, integrated care for frail older people. Future research should focus on unravelling the heterogeneity of frailty and on exploring what outcomes among frail older people may realistically be expected.
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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 OpenQuestion graph.