Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Table 2

Programs adopting at least one eHeath tool by general aspects of programs and health system characteristics of countries (% of programs).

General aspects of programs	National health model		value	Strength of PC		value	Level of (de)centralization		value	All programs; % ()
	NHS; % ()	SIS/TC; % ()		Strong/medium; % ()	Weak; % ()		Decentralized; % ()	Centralized; % ()
Main objectives^a
Increasing multidisciplinary collaboration	86.0 (49)	81.5 (22)	0.596	91.1 (51)	74.1 (20)	0.039	88.2 (45)	79.4 (27)	0.268	84.7 (72)
Improving patient involvement	78.9 (45)	66.7 (18)	0.225	80.4 (45)	66.7 (18)	0.172	80.4 (41)	67.6 (23)	0.182	75.3 (64)
Improving care coordination	78.9 (45)	55.6 (15)	0.027	82.1 (46)	51.9 (14)	0.004	76.5 (39)	64.7 (22)	0.238	71.8 (61)
Reducing hospital admissions	68.4 (39)	74.1 (20)	0.597	73.2 (41)	63.0 (17)	0.340	72.5 (37)	67.6 (23)	0.627	70.6 (60)
Decreasing/delaying complications	63.2 (36)	74.1 (20)	0.322	58.9 (33)	77.8 (21)	0.092	58.8 (30)	76.5 (26)	0.093	65.9 (56)
Reducing public costs	63.2 (36)	66.7 (18)	0.754	62.5 (35)	63.0 (17)	0.967	62.7 (32)	64.7 (22)	0.854	63.5 (54)
Improving accessibility of services	66.7 (38)	51.9 (14)	0.192	67.9 (38)	51.9 (14)	0.158	68.6 (35)	52.9 (18)	0.144	62.4 (53)
Organizations involved^a
Primary care	63.2 (36)	85.2 (23)	0.039	85.7 (48)	40.7 (11)	<0.001	88.2 (45)	44.1 (15)	<0.001	70.6 (60)
General hospital	66.7 (38)	55.6 (15)	0.324	57.1 (32)	74.1 (20)	0.135	60.8 (31)	64.7 (22)	0.715	62.4 (53)
University hospital	43.9 (25)	37.0 (10)	0.554	46.4 (26)	33.3 (9)	0.258	47.1 (24)	35.3 (12)	0.282	42.4 (36)
Health centre	38.6 (22)	37.0 (10)	0.891	42.9 (24)	25.9 (7)	0.135	41.2 (21)	32.4 (11)	0.411	37.6 (32)
Community/home care organization	40.4 (23)	29.6 (8)	0.342	44.6 (25)	25.9 (7)	0.101	45.1 (23)	26.5 (9)	0.082	37.6 (32)
Government	35.1 (20)	37.0 (10)	0.862	42.9 (24)	22.2 (6)	0.067	43.1 (22)	26.5 (9)	0.118	36.5 (31)
Policlinic/outpatient/ambulatory care	26.3 (15)	55.6 (15)	0.009	41.1 (23)	25.9 (7)	0.178	39.2 (20)	32.4 (11)	0.520	36.5 (31)
Care providers involved^a
General practitioner (GP)	73.7 (42)	92.6 (25)	0.044	91.1 (51)	59.3 (16)	0.001	88.2 (45)	67.6 (23)	0.020	80.0 (68)
Medical specialists	71.9 (41)	63.0 (17)	0.406	64.3 (36)	81.5 (22)	0.110	62.7 (32)	79.4 (27)	0.102	69.4 (59)
Districts/community nurses	57.9 (33)	48.1 (13)	0.402	71.4 (40)	25.9 (7)	<0.001	66.7 (34)	38.2 (13)	0.010	55.3 (47)
Hospital/specialized nurses	66.7 (38)	29.6 (8)	0.001	50.0 (28)	66.7 (18)	0.152	45.1 (23)	70.6 (24)	0.021	55.3 (47)
Physioterapist/exercise therapist	56.1 (32)	29.6 (8)	0.023	44.6 (25)	55.6 (15)	0.351	45.1 (23)	50.0 (17)	0.657	47.1 (40)
Home helps	38.6 (22)	37.0 (10)	0.891	48.2 (27)	22.2 (6)	0.023	47.1 (24)	26.5 (9)	0.056	38.8 (33)
Social workers	42.1 (24)	29.6 (8)	0.271	39.3 (22)	37.0 (10)	0.844	35.3 (18)	41.2 (14)	0.583	37.6 (32)
Integration level			0.771			0.318			0.332
Small-scale (pilot) program	22.8 (13)	29.6 (8)		21.4 (12)	33.3 (9)		21.6 (11)	32.4 (11)		25.9 (22)
Well-established and comprehensive program	29.8 (17)	29.6 (8)		28.6 (16)	33.3 (9)		27.5 (14)	32.4 (11)		29.4 (25)
Fully integrated in the regular healthcare system	47.4 (27)	40.7 (11)		50.0 (28)	33.3 (9)		51.0 (26)	35.3 (12)		44.7 (38)
Operational level			0.340			0.001			0.140
Only at level of policy/management	5.3 (3)	0.0 (0)		1.8 (1)	7.4 (2)		2.0 (1)	5.9 (2)		3.5 (3)
Only at level of daily patient care	36.8 (21)	29.6 (8)		23.2 (13)	59.3 (16)		27.5 (14)	44.1 (15)		34.1 (29)
Both (policy/management—patient care level)	57.9 (33)	70.4 (19)		75.0 (42)	33.3 (9)		70.6 (36)	50.0 (17)		62.4 (53)
Adoption level			0.120			0.001			0.001
Local	24.6 (14)	25.9 (7)		25.0 (14)	25.9 (7)		19.6 (10)	35.3 (12)		25.9 (22)
Regional	38.6 (22)	25.9 (7)		46.4 (26)	11.1 (3)		51.0 (26)	8.8 (3)		34.1 (29)
Local/regional, as part of a national program	10.5 (6)	33.3 (9)		19.6 (11)	14.8 (4)		21.6 (11)	11.8 (4)		17.6 (15)
National	15.8 (9)	7.4 (2)		3.6 (2)	29.6 (8)		3.9 (2)	26.5 (9)		12.9 (11)
National, as part of international programs	5.3 (3)	7.4 (2)		3.6 (2)	11.1 (3)		2.0 (1)	11.8 (4)		5.9 (5)
Inter-/supranational	5.3 (3)	0.0 (0)		1.8 (1)	7.4 (2)		2.0 (1)	5.9 (2)		3.5 (3)
Geographical coverage			0.822			0.429			0.339
Only rural	5.3 (3)	3.7 (1)		3.6 (2)	7.4 (2)		2.0 (1)	8.8 (3)		4.7 (4)
Only urban	10.5 (6)	14.8 (4)		10.7 (6)	18.5 (5)		13.7(7)	11.8 (4)		12.9 (11)
Both rural and urban areas	84.2 (48)	81.5 (22)		85.7 (48)	74.1 (20)		84.3 (43)	79.4 (27)		82.4 (70)
Types of care and support provided by programs^a
Medical care	78.9 (45)	77.8 (21)	0.903	82.1 (46)	70.4 (19)	0.223	78.4 (40)	79.4 (27)	0.914	78.8 (67)
Prevention/delay of deterioration	66.7 (38)	74.1 (20)	0.493	62.5 (35)	81.5 (22)	0.081	64.7 (33)	73.5 (25)	0.392	68.2 (58)
Nursing care	73.7 (42)	48.1 (13)	0.022	71.4 (40)	59.3 (16)	0.268	66.7 (34)	64.7 (22)	0.852	65.9 (56)
Lifestyle and health behaviour	63.2 (36)	74.1 (20)	0.322	66.1 (37)	66.7 (18)	0.957	64.7 (33)	67.6 (23)	0.779	65.9 (56)
Adherence to medication	63.2 (36)	66.7 (18)	0.754	66.1 (37)	59.3 (16)	0.545	72.5 (37)	50.0 (17)	0.034	63.5 (54)
Medical treatment interventions	66.7 (38)	59.3 (16)	0.508	57.1 (32)	74.1 (20)	0.135	56.9 (29)	73.5 (25)	0.118	63.5 (54)
Coordination of medical services	66.7 (38)	51.9 (14)	0.192	71.4 (40)	48.1 (13)	0.039	66.7 (34)	55.9 (19)	0.315	62.4 (53)

^aOnly items with higher % (first seven main %); multiple answers were allowed. Each item had a yes/no format.