Exploration of workforce changes in integrated chronic care: Findings from an interactive and emergent research design

Loraine Busetto, Katrien Luijkx, Stefano Calciolari, Laura Guadalupe González Ortiz, Hubertus Johannes Maria Vrijhoef

Research output: Contribution to journalScientific review

5 Citations (Scopus)


INTRODUCTION: Integrated care interventions introduced in response to the increased demand for long-term care entail profound changes to the health workforce. This exploratory study aims to provide an overview of the workforce changes implemented as part of integrated chronic care interventions.

METHODS: An interactive and emergent research design was used consisting of a literature review, qualitative expert questionnaires and case reports. We defined integrated care as interventions targeting at least two of the six Chronic Care Model components. Workforce changes were defined as those changes experienced by clinical and non-clinical staff responsible for public and individual health intervention.

RESULTS: Seven workforce changes were identified: (1) nurse involvement, (2) multidisciplinary staff, (3) multidisciplinary protocols/pathways, (4) provider training, (5) case manager/care coordinator, (6) team meetings, and (7) new positions. Most interventions included more than one of these workforce changes.

CONCLUSION: The results of this study provide detailed insights into the current implementation of workforce changes in integrated care interventions and thereby pave the way for further investigations into the relative effectiveness of different workforce changes within the scope of complex interventions. Advancing knowledge in this area is essential for fostering health systems' capacity to cope with the challenges related to the current demographic and epidemiological trends.

Original languageEnglish
Article numbere0187468
Number of pages21
JournalPLoS ONE
Issue number12
Publication statusPublished - 2017


  • Chronic Disease
  • Delivery of Health Care, Integrated/organization & administration
  • Health Personnel
  • Humans
  • Surveys and Questionnaires


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