Defining the characteristics of intermediate care models including transitional care: an international Delphi study
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ORIGINAL ARTICLE
Defining the characteristics of intermediate care models including transitional care: an international Delphi study Duygu Sezgin1 · Rónán O’Caoimh2 · Mark R. O’Donovan3 · Mohamed A. Salem4 · Siobhán Kennelly5 · Luz Lopez Samaniego6 · Cristina Arnal Carda7 · Rafael Rodriguez‑Acuña6 · Marco Inzitari8 · Teija Hammar9 · Claire Holditch10 · Janet Prvu Bettger11 · Martin Vernon12,13 · Áine Carroll14,15 · Felix Gradinger16,17 · Gaston Perman18 · Martin Wilson19 · Antoine Vella20 · Antonio Cherubini21 · Helen Tucker22 · Maria Pia Fantini23 · Graziano Onder24 · Regina Roller‑Wirnsberger25 · Luis Miguel Gutiérrez‑Robledo26 · Matteo Cesari27 · Paula Bertoluci28 · Magdalena Kieliszek29 · Wilma van der Vlegel‑Brouwer30 · Michelle Nelson31,32 · Leocadio Rodríguez Mañas33 · Eleftheria Antoniadou34 · François Barriere35 · Sebastian Lindblom36 · Grace Park37 · Isidoro Pérez38 · Dolores Alguacil39 · Douglas Lowdon40 · Maria Eugenia Alkiza41 · Cristina Alonso Bouzon42 · John Young43 · Ana Carriazo44 · Aaron Liew45,46 · Anne Hendry47,48 on behalf of European Union Advantage Joint Action Work Package 7 partners in collaboration with the International Foundation for Integrated Care Special Interest Group on Intermediate Care Received: 16 April 2020 / Accepted: 25 April 2020 © Springer Nature Switzerland AG 2020
Abstract Background Although there is growing utilisation of intermediate care to improve the health and well-being of older adults with complex care needs, there is no international agreement on how it is defined, limiting comparability between studies and reducing the ability to scale effective interventions. Aim To identify and define the characteristics of intermediate care models. Methods A scoping review, a modified two-round electronic Delphi study involving 27 multi-professional experts from 13 countries, and a virtual consensus meeting were conducted. Results Sixty-six records were included in the scoping review, which identified four main themes: transitions, components, benefits and interchangeability. These formed the basis of the first round of the Delphi survey. After Round 2, 16 statements were agreed, refined and collapsed further. Consensus was established for 10 statements addressing the definitions, purpose, target populations, approach to care and organisation of intermediate care models. Discussion There was agreement that intermediate care represents time-limited services which ensure continuity and quality of care, promote recovery, restore independence and confidence at the interface between home and acute services, with transitional care representing a subset of intermediate care. Models are best delivered by an interdisciplinary team within an integrated health and social care system where a single contact point optimises service access, communication and coordination. Conclusions This study identified key defining features of intermediate care to improve understanding and to support comparisons between models and studies evaluating them. More research is required to develop
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