The SELFIE framework for integrated care for multi-morbidity: development and description

Background: The rise of multi-morbidity constitutes a serious challenge in health and social care organi-sation that requires a shift from disease- towards person-centred integrated care. The aim of the currentstudy was to develop a conceptual framework that can aid the development, implementation, description,and evaluation of integrated care programmes for multi-morbidity.Methods: A scoping review and expert discussions were used to identify and structure concepts forintegrated care for multi-morbidity. A search of scientific and grey literature was conducted.Discussion: meetings were organised within the SELFIE research project with representatives of fivestakeholder groups (5Ps): patients, partners, professionals, payers, and policy makers.Results: In the scientific literature 11,641 publications were identified, 92 were included for data extrac-tion. A draft framework was constructed that was adapted after discussion with SELFIE partners from 8 EUcountries and 5P representatives. The core of the framework is the holistic understanding of the personwith multi-morbidity in his or her environment. Around the core, concepts were grouped into adaptedWHO components of health systems: service delivery, leadership & governance, workforce, financing,technologies & medical products, and information & research. Within each component micro, meso, andmacro levels are distinguished.Conclusion: The framework structures relevant concepts in integrated care for multi-morbidity and canbe applied by different stakeholders to guide development, implementation, description, and evaluation.