Cooperation capacity and quality in ageing: A longitudinal study of integrated care

During the last decade, a significant reduction in most of Sweden’s regions´ and cooperating municipalities´ quality of integrated care services for older persons has occurred, indicated by increasing proportions of unplanned hospital readmissions.

Cooperation size, focus, and time, may however, constitute important keys for the significant challenge of making integrated care equal and autonomous enough to generate the local-regional capacity needed to implement quality characterized by lower readmission rates.

The purpose of the project is to study the continuity and cooperation between health and care providers, which sustain and improve quality of integrated care services for older people, using readmission rates as a quality indicator. The research questions are: 1. Why has quality of integrated care services for older persons changed during the last decade? 2.

How has the capacity to cooperate between health and care providers changed after the last decade, and how might it be improved? 3. How is capacity to cooperate related to quality of integrated care: when, how, why does it succeed?

The project will rely on The Swedish National Board of Health and Welfare´s data on the proportion of unplanned hospital readmissions within 30 days among older persons living with multi-morbidity 2010-11 and 2018-19 in all 290 municipalities and 21 regions of Sweden, enabling search for systematic patterns of explanation across 60 cases of cooperation between health and care providers previously surveyed on cooperation capacity in 17 regions for the 2011-14 and 2015-18 terms of office.

New ways to improve cooperation will be revealed by similarly conducted surveys by Statistics Sweden before and after the 2022 general elections, in 2022 and in 2024, and a study representing the only case with decreasing readmission rates in a region among all municipalities. The aim is to make cooperation work again, after the 2019 decline in quality and after the pandemic.