Figure 1
Key elements of the DementiaNet program.
Figure 2
Rainbow Model of Integrated Care. Adapted with permission from Essenburgh Research & Consultancy [22].
Table 1
Characteristics of the DementiaNet primary dementia care networks.
| NETWORK | DISCIPLINES INVOLVED | DISCIPLINES INVOLVED | NETWORK LEADER(S) | NETWORK LEADER(S) CHANGED | NETWORK MEMBER CHANGES | COLLABORATION BEFORE DEMENTIANET | CATCHMENT AREA |
|---|---|---|---|---|---|---|---|
| AT START | END YEAR 2 | ||||||
| A | 1 GP; 1 PN; 2 CN; 2 CM; 1 GS (total: 7) | 1 GP; 1 PN; 2 CN; 2 CM; 1 GS (total: 7) | CM, GP | No | Some | Yes | Small |
| B | 3 GP; 3 CN; 2 CM; 1 GS; 1 OT; 1 PT; 1 WF; 1 MM (total: 13) | 2 GP; 4 CN; 2 CM; 2 GS; 2 OT; 1 PT; 1 WF; 1 MM (total: 15) | WF | Yes | Some | Yes | Large |
| C | 1 GP; 1 PN; 11 CN; 1 CM; 2 GS; 4 WF; 2 MM (total: 22) | 1 GP; 1 PN; 11 CN; 1 CM; 2 GS; 4 WF; 2 MM (total: 22) | GP, PN (both period absent) | No | Some | Yes | Large |
| D | 2 GP; 5 CN; 1 CM; 2 WF (total: 10) | 2 GP; 5 CN; 1 CM; 2 WF (total: 10) | CM, CN (both period absent) | No | Many | No | Large |
| E | 2 GP; 1 PN; 2 CN; 1 CM; 1 GS; 1 WF (total: 8) | 2 GP; 1 PN; 2 CN; 1 CM; 1 GS; 1 PH; 1 WF; 1 PT (total: 10) | PN, CM | No | Some | No | Small |
| F | 2 GP; 2 PN; 1 CN; 1 CM; 1 IC (total: 7) | 2 GP; 2 PN; 1 CN; 1 CM; 1 IC (total: 7) | PN, CM | No | None | No | Large |
| G | 2 GP; 2 CN; 1 CM; 1 WF (total: 6) | 1 GP; 2 CM; 1 WF; 1 MM (total: 5) | GP, CM | No | Some | Yes | Small |
| H | 2 GP; 4 CN; 1 CM; 2 GS; 1 OT; 5 WF; 1 IC (total: 16) | 2 GP; 3 CN; 1 CM; 2 GS; 1 OT; 1 PT; 5 WF; 1 IC (total: 16) | CN | No | Some | No | Large |
| I | 1 GP; 1 PN; 1 CN; 1 CM; 1 MM (total: 5) | 1 GP; 1 PN; 1 CN; 1 CM (total: 4) | CN | No | Some | No | Small |
| J | 1 CN; 2 CM; 1 OT; 1 PH; 2 WF; 2 MM; 3 other (total: 12) | 3 PN; 3 CN; 2 CM; 1 OT; 2 PH; 3 WF; 1 MM; 3 other (total: 18) | WF, OT | No | Some | No | Small |
| K | 1 GP; 9 CN; 1 CM (total: 11) | 1 GP; 9 CN; 3 CM (total: 13) | CN, CM | No | Some | No | Small |
| L | 1 GP; 1 PN; 1 CN; 1 CM; 1 GS; 1 WF (total: 6) | 1 GP; 1 PN; 1 CN; 1 CM; 1 GS; 1 WF (total: 6) | PN | No | None | No | Large |
| M | 1 GP; 2 CN; 1 CM (total: 4) | 1 GP; 2 CN; 1 CM (total: 4) | CN | No | None | No | Small |
| N | 1 GP; 1 PN; 2 CM; 2 GS (total: 6) | 1 GP; 1 PN; 2 CM; 2 GS (total: 6) | PN | No | None | Yes | Small |
| O | 1 GP; 1 PN; 2 CN; 1 GS (total: 5) | 2 GP; 1 PN; 1 CM; 1 GS (total: 5) | PN | Yes | Many | No | Large |
| P | 1 GP; 1 POH; 2 CN; 1 CM; 1 GS; 1 WF (total: 7) | 1 GP; 1 POH; 2 CN; 1 CM; 1 GS; 1 WF (total: 7) | PN | No | None | No | Large |
| Q | 1 GP; 2 POH; 2 CN; 1 CM; 1 GS (total: 7) | 1 GP; 2 POH; 2 CN; 1 CM; 1 GS (total: 7) | PN | Yes | None | No | Small |
[i] Catchment area: area from which the network attracts its population of patients with dementia, defined by geographical size and population distribution and density; large = more than approximately 7,500 persons. GP = general practitioner; PN = practice nurse; CN = community nurse; CM = case manager; GS = geriatric specialist; PH = pharmacist; OT = occupational therapist; PT = physiotherapist; WF = welfare worker; MM = management or municipality; IC = informal caregiver.
Figure 3
Network maturity trajectories of all networks with Network Maturity Scores on a scale of 1–4. Dashed lines represent networks with an existing collaboration, solid lines represent new networks and the bold line is the mean.
Table 2
Total and domain specific Network Maturity scores on T0, T1 and T2 (Crude means and standard deviations; β-coefficients, 95 % confidence intervals and p-values).
| T0 | T1 | T2 | LINEAR MIXED MODELS | |||||
|---|---|---|---|---|---|---|---|---|
| MEAN | SD | MEAN | SD | MEAN | SD | BÈTA (95% CI) | p | |
| Total network maturity | 1.66 | 0.53 | 2.11 | 0.50 | 2.24 | 0.50 | 0.29 (0.20–0.38) | <0.001 |
| Scope | ||||||||
| Person-focused care | 1.38 | 0.57 | 1.72 | 0.60 | 2.06 | 0.66 | 0.27 (0.18–0.36) | <0.001 |
| Population-based care | 1.53 | 0.78 | 2.13 | 0.76 | 2.27 | 0.69 | 0.23 (0.13–0.33) | <0.001 |
| Type | ||||||||
| Clinical integration | 1.65 | 0.79 | 2.13 | 0.76 | 2.21 | 0.66 | 0.16 (0.06–0.26) | 0.003 |
| Professional integration | 1.59 | 0.75 | 2.41 | 0.64 | 2.56 | 0.58 | 0.32 (0.22–0.43 | <0.001 |
| Organizational integration | 1.97 | 0.33 | 2.22 | 0.36 | 2.32 | 0.50 | 0.05 (–0.01–0.11) | 0.108 |
| System integration | 1.96 | 0.56 | 2.25 | 0.5 | 2.03 | 0.62 | 0.05 (–0.04–0.15) | 0.246 |
| Enablers | ||||||||
| Functional integration | 1.47 | 0.65 | 1.84 | 0.63 | 2.09 | 0.59 | 0.4 (0.09–0.71) | 0.012 |
| Normative integration | 1.82 | 0.68 | 2.25 | 0.66 | 2.44 | 0.68 | 0.18 (0.07–0.28) | 0.001 |
[i] SE = standard error, significant at p-value below 0.05, 95% CI = confidence interval.
Figure 4
Patterns of the network maturity score trajectories over time for the networks. A.) Trajectories of networks where network maturity improved; B.) Trajectories of networks that maintained their high network maturity; and C.) Trajectories of networks where network maturity was not improved or sustained.