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Table 1 Description of the domains of the revised RMIC

From: Value-based integrated (renal) care: setting a development agenda for research and implementation strategies

Main domains Subdomain Description
Triple Aim Outcomesa
 Experience of care Satisfaction Patient-reported measures addressing the satisfaction (or barriers) of the service delivery.
  Quality of careb Factors related to the quality of care (e.g. patient safety, timeliness, responsiveness, accessibility).
 Population health Mortality Health outcomes related to mortality measures for a general or specific (sub)population (e.g. life expectancy, standardized mortality, healthy life expectancy).
  Morbidity Health outcomes related to patient reported functional status measures (e.g. HRQOL-4, SF-12, EuroQol).
  Disease Burden Health outcomes related to the incidence and prevalence of (major) chronic conditions (e.g. diabetes, heart diseases, chronic obstructive pulmonary disease).
  Behavioural factors Health outcomes related to behavioural factors (e.g. smoking, diet and physical activity)
  Physiological factors Health outcomes related to physiological factors (e.g. body mass index, cholesterol and blood glucose).
 Cost and utilization Cost per capita Total (direct and indirect) costs and costs by type of service of a particular population per time unit (month, year).
  Utilization of services Total volume of service use visits (e.g. number of hospital, emergency department) for per a particular population per time unit (month, year).
RMIC domainsc
 Scale of integration Universal population (macro) Universal strategies and interventions designed to promote the general health or reduce the risk of developing health problems in a population.
  Targeted sub-groups (meso) Targeted strategies and interventions designed for a subpopulations at risk (based on their age, gender, genetic history, condition, or situation) of developing a (severe) disease.
  Targeted individuals (micro) Targeted strategies and interventions designed for persons at extremely high risk or who already show (a)symptomatic or clinical ‘abnormalities.’
 Type of integration System integration (macro) Coherent set of (informal and formal) political arrangements to facilitate professionals and organisations to deliver a comprehensive continuum of care for the benefit of the general population.
  Organisational integration (meso) Inter-organisational partnerships (e.g. agreements, contracting, strategic alliances, knowledge networks, mergers) based on collaborative accountability and shared governance mechanisms, to deliver a comprehensive continuum of care to targeted sub-groups at risk.
  Professional integration (meso) Inter-professional partnerships based on a shared understanding of competences, roles, responsibilities and accountability to deliver a comprehensive continuum of care to targeted subgroups at risk.
  Clinical integration (micro) Coordination of person-focused care for a complex need at stake in a single process across time, place and discipline.
 Enablers of integration Functional integration (micro-macro) Communication mechanisms and tools (i.e. financial, management and information systems) structured around the primary process of service delivery that provide optimal information as a feedback mechanism for decision support between organisations, professional groups and individuals.
  Normative integration (micro-macro) Mutually respected cultural frame of reference (i.e. shared mission, vision, values and behaviour) between organisations, professional groups and individuals to achieve shared goals towards the Triple Aim outcomes.
  1. aCategorization of the Triple Aim domains is based in the IHI’s ‘Guide to measuring the Triple Aim’ [96]
  2. bCategorization based on the Institute of Medicine’s six aims for improvement [97]
  3. cCategorization of performance domains are based on the RMIC [21]