Evaluating the impact of delivering health and social care to older people in Wales

Service evaluations need to evaluate the impact of integrated services on individual’s. The social model of care takes into account quality of life issues and provides a more holistic account of the potential benefits of integrated care. The hard evidence to suggest that integrated care produces benefits to the service user, carer, family or professional is largely absent and cost benefit not available. Cost efficiencies of delivering care is measured by performance output but whether this can be translated into cost effectiveness when compared to traditional forms of service delivery is not evident. Aim: To develop an integrated care evaluation framework using performance outputs and personal and social outcomes to measure and evaluate the impact of delivering integrated care to older individuals and their households. Method: A realistic evaluation reviewed literature, policy and strategy and stakeholder experiences to understand the context, mechanisms and outcomes associated with delivering integrated care. Results: A service user evaluation framework was designed to understand the outcomes of integrated care over 3 domains. Micro: the individual user, carers and family, Meso: management of services, Macro: Impact on policy and strategy. Conclusion: The evaluation framework robustly and consistently evaluates services, while accounting for differences in approach, context and mechanisms.