Defining the characteristics of intermediate care models including transitional care: an international Delphi study

European Union Advantage Joint Action Work Package 7 partners in collaboration with the International Foundation for Integrated Care Special Interest Group on Intermediate Care, Duygu Sezgin, Rónán O’Caoimh, Mark R. O’Donovan, Mohamed A. Salem, Siobhán Kennelly, Luz Lopez Samaniego, Cristina Arnal Carda, Rafael Rodriguez-Acuña, Marco Inzitari, Teija Hammar, Claire Holditch, Janet Prvu Bettger, Martin Vernon, Áine Carroll, Felix Gradinger, Gaston Perman, Martin Wilson, Antoine Vella, Antonio CherubiniHelen Tucker, Maria Pia Fantini, Graziano Onder, Regina Roller-Wirnsberger, Luis Miguel Gutiérrez-Robledo, Matteo Cesari, Paula Bertoluci, Magdalena Kieliszek, Wilma van der Vlegel-Brouwer, Michelle Nelson, Leocadio Rodríguez Mañas, Eleftheria Antoniadou, François Barriere, Sebastian Lindblom, Grace Park, Isidoro Pérez, Dolores Alguacil, Douglas Lowdon, Maria Eugenia Alkiza, Cristina Alonso Bouzon, John Young, Ana Carriazo, Aaron Liew, Anne Hendry

Research output: Contribution to journalArticlepeer-review


Background: Although there is growing utilisation of intermediate care to improve the health and well-being of older adults with complex care needs, there is no international agreement on how it is defined, limiting comparability between studies and reducing the ability to scale effective interventions. Aim: To identify and define the characteristics of intermediate care models. Methods: A scoping review, a modified two-round electronic Delphi study involving 27 multi-professional experts from 13 countries, and a virtual consensus meeting were conducted. Results: Sixty-six records were included in the scoping review, which identified four main themes: transitions, components, benefits and interchangeability. These formed the basis of the first round of the Delphi survey. After Round 2, 16 statements were agreed, refined and collapsed further. Consensus was established for 10 statements addressing the definitions, purpose, target populations, approach to care and organisation of intermediate care models. Discussion: There was agreement that intermediate care represents time-limited services which ensure continuity and quality of care, promote recovery, restore independence and confidence at the interface between home and acute services, with transitional care representing a subset of intermediate care. Models are best delivered by an interdisciplinary team within an integrated health and social care system where a single contact point optimises service access, communication and coordination. Conclusions: This study identified key defining features of intermediate care to improve understanding and to support comparisons between models and studies evaluating them. More research is required to develop operational definitions for use in different healthcare systems.

Original languageEnglish
Pages (from-to)2399-2410
JournalAging clinical and experimental research
Issue number11
Publication statusPublished - 2020


  • Care models
  • Definition
  • Delphi technique
  • Integrated care
  • Intermediate care
  • Older adults
  • Transitional care

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology


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