Cultura

Reconceptualizing Healthcare Delivery Through Multidisciplinary Integration: A Comprehensive Review And Conceptual Framework

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Abdulaziz Dayel Saleh Al Dundur, Yahya Saeed H alyami, Hmoud Rabee Alblawi, Naif Saleh Al-Dhiryan, Majed Mohammed Zaila, Abdulsalam Naif Alshammari
Mohsen Hassan Yahya AlQurayshah, Ali Yahya Mohammed Alzubaidi, Mohammed Mahdi Saeed Al Saleem, Mohammed Saleh Abdullah Sawwan, Nabeel Mohsen Aldhayriyan, Hamad Ali Hossin Alabbas

Abstract

Modern healthcare systems face increasing complexity due to rising patient acuity, chronic disease burden, and rapid technological advancement. Traditional silo-based models of care are no longer sufficient to meet the demands of quality, safety, and efficiency in healthcare delivery. This comprehensive review aims to reconceptualize healthcare delivery through the lens of multidisciplinary integration, examining how coordinated collaboration among clinical, diagnostic, therapeutic, and supportive medical departments influences patient care and system performance. Drawing on evidence from international literature published between 2016 and 2025, the review synthesizes findings on multidisciplinary practice across key domains, including patient safety, clinical outcomes, operational efficiency, and patient experience. The analysis highlights that effective integration—supported by organizational governance, workforce readiness, and digital health enablers—reduces medical errors, enhances clinical decision-making, and improves continuity of care across the care continuum. Based on the synthesized evidence, a comprehensive conceptual framework is proposed to illustrate the relationships between multidisciplinary structures, integration mechanisms, care processes, and outcomes. This review contributes to the growing body of health systems research by offering an integrative perspective that can guide healthcare leaders, policymakers, and researchers in designing and implementing more resilient, patient-centered, and high-performing healthcare delivery models.

Keywords : Multidisciplinary Integration; Integrated Healthcare Delivery; Health Systems Performance; Patient Safety; Clinical Outcomes; Conceptual Framework.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty