Management im Gesundheitswesen


SELFIE: ‘Sustainable intEgrated care modeLs for multi-morbidity: delivery, FInancing and performancE

SELFIE is a Horizon2020 EU project that will contribute to the current state of knowledge and provide applicable policy advice on integrated care for persons with multi-morbidity.

Currently, over 50 million persons in Europe have more than one chronic disease, and this number will increase dramatically in the near future. As a consequence, health care spending will increase to a staggering 20% of GDP. Multi-morbidity will become the number one threat to population health and economic sustainability of health care systems. New models of care for multi-morbid persons are thus needed.

SELFIE aims to improve person-centered care for persons with multi-morbidity by proposing evidence-based, economically sustainable, integrated chronic care models that stimulate cooperation across health and social care sectors. These models must also be supported by appropriate financing/payment schemes.


There are three main strands of research in the SELFIE project:

  1. Cross-country comparative descriptive research of Integrated Chronic Care (ICC) models for persons with multi-morbidity, including a list of financial/payment schemes that support the implementation of these models;
  2. Intra-country evaluations of financing/payment schemes of ICC models, and Multi-Criteria Decision Analyses (MCDA) of the 16 most promising ICC models;
  3. Evidence synthesis, and development of implementation strategies that match the different healthcare systems in Europe, and support the transferability of the ICC models also to Central and Eastern European Countries.


SELFIE has 5 main deliverables:

  1. Taxonomy of most promising ICC models for multi-morbid persons. This includes a toolkit of interventions to develop ICC models and embed them in specific health and social care systems.
  2. List of financing/payment schemes with adequate incentives to support the implementation of ICC for multi-morbidity.
  3. Price-setting document explaining the technicalities of deriving a price for ICC models.
  4. Performance assessment tool to monitor the goal achievement of ICC models, this tool will include new indicators that specifically address the quality of care for persons with multi-morbidity.
  5. Strategies for implementation and change management.

The project is led by prof.dr. Maureen Rutten-van Mölken of the Institute of Health Policy and Management of the Erasmus University Rotterdam.


Stakeholder Advisory Board

In the SELFIE project a Stakeholder Advisory Board (SAB) has been installed. Representatives from all ‘5P’ stakeholder groups make up this board:

I. Patients with multi-morbidity,

II. Partners and family members of patients with multi-morbidity who often take the role of informal caregivers,

III.Professionals and organizations who provide health and social care, and professionals who conduct research in this field,

IV.Payers, such as health care budget holders and health insurers, and

V. Policy makers.

Overview Work Packages

  • Work package 1: Title: Conceptual framework to review integrated chronic care for multi-morbidity models and select promising projects

Main objectives:

  1. To develop a conceptual framework to describe and evaluate ICC models for multi-morbidity.
  2. To develop criteria to identify promising ICC multi-morbidity projects.
  3. To score and rank ICC multi-morbidity projects in the partner countries and several other countries (i.e., Canada, USA, Australia, New Zealand, and Israel) on these criteria.
  4. To select 16 most promising ICC multi-morbidity projects.

Approach: The conceptual framework will be developed through a systematic review, re-analysis of results from previous and current projects, exploration of grey literature, and a survey among project partners. The same approaches will be used to identify promising ICC multi-morbidity projects. The conceptual framework will be used to create a method by which to score and select these projects. We will strive to select 16 projects on the basis of the criteria ranking as well as on their ‘evaluability’. The aim is to include 2 projects from each partner country, which will be studied and described in detail in WP2 and evaluated in WP5. Leading partner: Technical University Berlin (TUB), Department of Health Care Management, Germany Other partners involved:

  1. Institute for Advanced Studies (IHS), Department of Economics and Finance, Austria
  2. Erasmus University Rotterdam (EUR), Institute of Health Policy and Management (iBMG), Netherlands
  3. University of Bergen (UiB), Department of Economics, Norway
  4. Syreon Research Institute (SRI), Hungary
  5. University of Manchester (UNIMAN), Manchester Centre for Health Economics (MCHE), United Kingdom
  6. Agency for Quality and Accreditation in Health Care and Social Welfare (AAZ), Department for Development, Research and HTA, Croatia
  7. Consorci Institut D’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic de Barcelona, Spain
  • Work package 2: Title: Comprehensive description of the most promising integrated chronic care projects for multi-morbidity
  • Work package 3: Title: Impact of financing/payments schemes and price-setting of integrated chronic care for multi-morbidity
  • Work package 4: Title: Development of an analytical framework to perform evaluations using Multi-Criteria Decision Analysis (MCDA)
  • Work package 5: Title: Comprehensive evaluations of promising integrated chronic care projects for multi-morbidity using MCDA
  • Work package 6: Title: Evidence synthesis and implementation strategies
  • Work package 7: Title: Transferability to Central- and Eastern Europe (CEE)