Continuity of care: models and pillars. Findings of a literature review. Continuità assistenziale: modelli e pilastri. Risultati di una revisione della letteratura

Objectives: the aim of this study has been to review international models and approaches supporting the continuum of care and to identify their main focuses. Methods: a narrative review was performed on Pubmed using the inclusion criteria: continuity of care models application with particular reference to chronicity, comorbidity, disability or frailty areas; systematic reviews written in English or Italian. Results: from 129 initial records, 22 studies were selected. Within these, the most commonly treated is the integrated care model, analysed by 41% of the studies. Moreover, the presence of pillars (founding elements) common to multiple models emerged: “patient engagement and empowerment” (86% of the studies); “multidisciplinarity” (73% of the studies); “coordination of care” (50% of the studies) and “case management” (50% of the studies). Conclusions: the key elements and pillars of the analysed continuum of care models are all interconnected and have to be considered as a part of a holistic care process that aims to respond to the different and complex patient’s health needs. Continuity of care requires the delivery system to adopt a primary health care orientation emphasising the comprehensiveness of the care process and the overall health of the patient and implementing multicomponent and multilevel interventions based approaches.