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- Title
Human Flourishing and Integrated Care Models: The Development of the Flourish Index.
- Authors
Faul, Anna C; D'Ambrosio, Joseph G; Yankeelov, Pamela A; Cotton, Samantha G; Furman, Christian D; Hall-Faul, Madri; Gordon, Barbara; Wright, R Brent
- Abstract
Background and Objectives In evaluating integrated care models, traditional quality measures do not account for functional and quality of life factors, affecting older adults with multiple chronic conditions. The objective of this study was the development and validation of the Flourish Index (FI), an instrument to evaluate integrated care, using a determinants of health model. Research Design and Methods The study took place within the evaluation study of the Flourish Model (FM). The FM provides care coordination services using an integrated primary care and community-based services model. Baseline data from 70 older adults were used in the validation study. Twenty-seven quality of care indicators within six determinants of health, namely biological, psychological, individual health behaviors, health services, environmental, and social, formed part of the FI. Results Categorical principal components analysis showed a 5-dimensional structure with psychological determinants loading on the biological determinants of health. Internal consistency (Cronbach's alpha) for the determinants was as follows: biological/psychological = 0.73, individual = 0.58, environmental = 0.62, health services = 0.65, social = 0.67, total score = 0.97. Sensitivity to change was shown for the total FI score (F 1,22 = 8.82, p =.01) and social (F 1,22 = 5.82, p =.02), with a trend toward sensitivity for individual health behaviors (F 1,22 = 3.95, p =.06) and health services (F 1,22 = 3.26, p =.09). Discussion and Implications The preliminary analysis of the FI shows promise for the usability of the index to provide insight into the fundamental challenges of aging. It brings greater clarity in caring for older adults and supports quality evaluation of integrated care coordination models.
- Subjects
ELDER care; COMMUNITY health services; STATISTICAL correlation; ENVIRONMENTAL health; EXPERIMENTAL design; FACTOR analysis; HEALTH behavior; HUMAN rights; INTEGRATED health care delivery; RESEARCH methodology; MEDICAL care; MEDICAL quality control; PRIMARY health care; RESEARCH evaluation; SOCIAL skills; SOCIAL support; RESEARCH methodology evaluation; HEALTH &; social status
- Publication
Gerontologist, 2019, Vol 59, Issue 6, pe653
- ISSN
0016-9013
- Publication type
Article
- DOI
10.1093/geront/gny114