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Table 1 Main characteristics of the four assessment protocols

From: Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols

Protocol Aims Study design & Measurements Intervention group Comparator group Expected outputs
(1) Population-based study (1.1) Impact of integrated care on cost-effectiveness (1.1) Case control study matching registry data using PSM methods (2011–2017) (Additional file 1: Table S1) (1.1 and 1.2) Residents living in the healthcare district of Barcelona-Esquerra (n = 516 K inhabitants) (1.1 and 1.2) Residents living in the other 3 healthcare districts of Barcelona (~ 400 k inhabitants each), as well as the entire region of Catalonia (n = 7.5 M inhabitants) (1.1a) Health value generation of integrated care
(1.2) Enhanced health risk assessment and service selection (1.2) Fixed cohort study (1.1b) Enhanced Key Performance Indicators (KPI) for long-term assessment of integrated care
(1.2) Proposal for health risk assessment for service selection
(2) Home hospitalization (2.1) Assessment of hospital avoidance and early hospital discharge at district level (2.1) Prospective controlled cohort study using PSM methods (2017–2018) (Additional file 2: Table S2) (2.1) All patients admitted to the home hospitalization directly from the emergency room (n = 800 patients). Study of a deeply characterized subset (triple aim approach) of 200 patients. This subset will be used to generate (2.2). (2.1) Patients admitted to conventional hospitalization directly from the emergency department of the same hospital (n = 800 patients). Study of a deeply characterized subset (triple aim approach) of 200 patients. This subset will be used to generate (2.2). (2.1a) Health value generation of the service; expanded HDA using MCDA (n = 200). Factors modulating success of the implementation strategy.
(2.2) Observational mixed-methods study combining network and cluster analyses with qualitative methodologies
(2.2) Recommendations for shared-care agreements between specialized and community-based care
(2.1b) KPI for service assessment
(2.2) Strategies for enhanced interactions between specialized-community-based care.
(3) Prehabilitation (3.1) Sustainability (cost-effectiveness of prehabilitation at HCB (3.1) Prospective controlled cohort study using PSM methods (2016–2018) (Additional file 3: Table S3) (3.1) All candidates for major surgery at HCB receiving prehabilitation (n = 500) (3.1) Candidates for major surgery at HCB receiving usual care in the same hospital (n = 250) (3.1a) Health value generation of prehabilitation at HCB
(3.2) Recommendations for transition toward a regional peri-operative care program (3.2) Randomized controlled trial to assess peri-operative care (3.2) Candidates for major surgery at HCB receiving peri-operative care (n = 60) (3.1b) KPI for service assessment
(3.3) Enhanced pre-operative risk assessment (3.3) Fixed cohort study (3.3) All surgical patients in the last 5 years at HCB (3.2) Candidates for major surgery at HCB receiving usual care (n = 60)
(3.2) Cost-effectiveness of peri-operative care and strategies for regional deployment.
(3.3) Risk assessment tool for personalized prehabilitation
(4) Frail elderly patients (4.1) Assessment of community-based integrated care services for frail patients at BSA (4.1) Prospective controlled cohort study using PSM methods (2018) (Additional file 4: Table S4) (4.1) Individuals enrolled in BSA integrated care programs for frail elderly that includes: i) Early Discharge support (n = 144); ii) Long-term home-based support services (n = 566) and iii) Geriatric residences care (n = 920) (4.1) Individuals living in Badalona receiving usual care: i) After hospital discharge (n = 144), ii) At home (n = 566); and, iii) Living at geriatric residences (n = 920) (4.1a) Cost-effectiveness of the service; and, expanded HDA using MCDA (n = 250). Factors modulating success of the implementation strategy.
(4.1b) KPI for service assessment
  1. Abbreviations: HDA Health Delivery Assessment, MCDA Multi-Criteria Decision Analysis, HCB Hospital Clinic de Barcelona, PSM Propensity Score Matching, KPI Key Performance Indicators for service long-term assessment after the deployment phase, BSA Badalona Serveis Asssistencials