SELFIE - Sustainable Integrated Care Models For Multi-Morbidity: Delivery, Financing and Performance

Currently, over 50 million persons in Europe have more than one chronic disease (multimorbidity): This number will increase dramatically in the near future. As a consequence, health care spending will increase to a staggering 20% of GDP. Multimorbidity will become the number one threat to population health and economic sustainability of health care systems. New models of care for multi-morbid persons are urgently needed. Given the diversity of Europe's health and social care system, there is no single model that fits all countries and health systems, but the need is great to learn from each other and see what measures can work.

The Horizon2020 EU project SELFIE is coordinated from Erasmus University Rotterdam. It is based on collaboration between universities and institutes in 7 countries: the Netherlands, England, Norway, Germany, Croatia, Austria, Hungary and Spain. The Norwegian partner is the Department of economics, University of Bergen, in cooperation with Uni Research Health and Uni Research Rokkan Centre.

SELFIE comprises 7 work packages (WPs):

In WP1, we developed a conceptual framework for integrated care for people with multimorbidity. In WP2, the 8 participating countries described a total of 17 promising integrated health / care programs, using document analyzes and interviews. In WP3 payment systems were described and classified according to the degree of integration. In WP4, we developed the methodology for Multi-Criteria Decision Analysis (MCDA). In WP5, we use this method to evaluate the effect of each integrated program compared to a control group. The same core set of outcomes is measured in all programs. In addition, the outcomes are weighted according to their importance of five groups of respondents, the 5 «P's» (patients, partners / informal caregivers, professions, payers) and policy makers.

In Norway we evaluate two models for integrated health- and care services for two different groups with multimorbidity: Learning network for good patient pathways (elderly and people with chronic diseases) and Medication-assisted rehabilitation (MAR) Bergen (people with opioid addiction).

Currently we conduct a broad evaluation of the two models with regard to contribution to better patient health and welfare, and lower costs. Design: prospektive cohort studies with control group. The studies comprise questionnaire and registry data collected from 300 patients in municipalities that have implemented the model, and 300 patients from similar municipalities that have not (yet) implemented the model. Data will be collected twice, at baseline and after 6 months.

Further information on webside: http://www.selfie2020.eu/

Principle investigator: Erasmus University Rotterdam, Nederland

Project leader in Norway is Jan Erik Askildsen (Department of economics/UoB). Other project contributors: Sabine Ruths (NORCE), Kamrul Islam (NORCE), Kristian Jansen (NORCE), Rune Ervik (NORCE), Tord Skogedal Linden (NORCE), Kjell-Arne Johansson (UoB), Lars Thore Fasnes (UoB) og Christian Ohldieck (MAR Bergen)

Funding: Horizon2020, grant agreement number 634288

Updated: 19.09.18