Integrated care for chronic conditions: The contribution of the ICCC Framework

Basque Institute for Healthcare Innovation, Plaza Asua 1, 48150 Sondika, Vizcaya, Spain.
Health Policy (Impact Factor: 1.91). 11/2011; 105(1):55-64. DOI: 10.1016/j.healthpol.2011.10.006
Source: PubMed


The aim of this research is to highlight the current relevance of the Innovative Care for Chronic Conditions (ICCC) Framework, as a model for change in health systems towards better care for chronic conditions, as well as to assess its impact on health policy development and healthcare redesign to date.
The authors reviewed the literature to identify initiatives designed and implemented following the ICCC Framework. They also reviewed the evidence on the effectiveness, cost-effectiveness and feasibility of the ICCC and the earlier Chronic Care Model (CCM) that inspired it.
The ICCC Framework has inspired a wide range of types of intervention and has been applied in a number of countries with diverse healthcare systems and socioeconomic contexts. The available evidence supports the effectiveness of this framework's components, although no study explicitly assessing its comprehensive implementation at a health system level has been found.
As awareness of the need to reorient health systems towards better care for chronic patients grows, there is great potential for the ICCC Framework to serve as a road map for transformation, with its special emphasis on integration, and on the role of the community and of a positive political environment.

66 Reads
    • "These levels extend the involvement of community and describe policies and financing as the drivers at the macro level (Bengoa et al., 2004). Nuño et al. (2012) suggest the need for further studies which explicitly assess the implementation of the Innovative Care for Chronic Conditions Framework at health system level, but argued that many components of it had been assessed in the literature that is related to the Chronic Care Model previously. A study conducted in the United States of America, recently identified that chronic disease education, specifically support and self management was not well integrated into their undergraduate nursing curricula (Kuebler et al., 2014). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The Chronic Care Model developed by Wagner is recognised to provide a systematic approach to managing chronic care. It has been adapted by the World Health Organization to become the Innovative Care for Chronic Conditions Framework. Together these have been demonstrated to provide an effective framework for chronic care management in a variety of settings. In order to prepare Australian nursing graduates for a changing health system it is important to recognise global issues and to prepare them to work within well recognised models. This paper examines the publically available documentation of pre-registration nursing degrees in Australia for their alignment with the Chronic Care Model and the Innovative Care for Chronic Conditions Framework. Those aspects of each which are well addressed are identified along with those which could be improved. Copyright © 2015 Elsevier Ltd. All rights reserved.
    No preview · Article · Aug 2015 · Nurse education today
  • Source
    • "Chronic diseases in the developing countries account for 0.02% to 6.77% of the United States national GDP (WHO, 2011). By 2030 almost 80% of the human deaths globally will be due to chronic diseases (Samb et al., 2010; Nuno et al., 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic diseases are lifelong medical conditions that evolve over the lifespan of a person. Even if they can be treated and controlled, their long-term effects pose great pressure to the global health supply chains. Motivated by the need for active and sustainable interventions in the healthcare sector, we provide a first-effort approach to capture their behavior by focusing on the chronic disease patient flow. The latter delivers the necessary dynamic patterns to health supply chains, when an in-depth analysis is prerequisite to face strategic managerial problems related to issues such as social aspects (patients’ quality of life), health insurance, pharmaceutical industry, etc. To this end, firstly, we identify the major echelons of this health supply chain and we outline the respective physical flows. Secondly, we develop a System Dynamics (SD) model using a numerical example that illustrates the behavior of the system over a period of seven years. Finally, we proceed to suggestions for on-going research highlighting the need to capture the non-linear complex dynamic behavior of the chronic disease patient process. The proposed framework and the SD model provide an overview of the process of the patients that suffer from chronic disease issues. The model could be a tool for shaping public policies and outline appropriate business strategies for the benefit of all the market stakeholders.
    Full-text · Conference Paper · May 2015
  • Source
    • "Evidence in other chronically ill patient populations shows that the healthcare system (e.g. level of chronic illness management (CIM)) and patient selfmanagement (e.g. adherence) drive improvements in outcomes (Nuno et al. 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: AimThis article describes the rationale, design and methodology of the Building research initiative group: chronic illness management and adherence in transplantation (BRIGHT) study. This study of heart transplant patients will: (1) describe practice patterns relating to chronic illness management; (2) assess prevalence and variability of non-adherence to the treatment regimen; (3) determine the multi-level factors related to immunosuppressive medication non-adherence.Background The unaltered long-term prognosis after heart transplantation underscores an urgent need to identify and improve factors related to survival outcomes. The healthcare system (e.g. level of chronic illness management implemented) and patient self-management are major drivers of outcome improvement.DesignThe study uses a survey design in 40 heart transplant centres covering 11 countries in four continents.Methods Theoretical frameworks informed variable selection, which are measured by established and investigator-developed instruments. Heart transplant recipients, outpatient clinicians and programme's directors complete a survey. A staged convenience sampling strategy is implemented in heart transplant centres, countries and continents. Depending on the centre's size, a random sample of 25–60 patients is selected (N estimated 1680 heart transplant recipients). Five randomly selected clinicians and the medical director from each centre will be invited to participate.Conclusion This is the first multi-centre, multi-continental study examining healthcare system and heart transplant centres chronic illness management practice patterns and potential correlates of immunosuppressive medication non-adherence. The knowledge gained will inform clinicians, researchers and healthcare policy makers at which level(s) interventions need to be implemented to improve long-term outcomes for transplant recipients.
    Full-text · Article · Sep 2014 · Journal of Advanced Nursing
Show more