What are the priorities for the future development of integrated care? A scoping review

Abstract

Purpose“Integrated care” (IC) is an approach to health and social care delivery that aims to prevent problems arising from fragmented care systems. The collective content of the IC literature, whilst valuable, has become extensive and wide-ranging to such a degree that knowing what is most important in IC is a challenge. This study aims to address this issue.Design/methodology/approachA scoping review was conducted using Arksey and O'Malley's framework to determine IC priority areas.FindingsTwenty-one papers relevant to the research question were identified. These included studies from many geographical regions, encompassing several study designs and a range of populations and sample sizes. The findings identified four priority areas that should be considered when designing and implementing IC models: (1) communication, (2) coordination, collaboration and cooperation (CCC), (3) responsibility and accountability and (4) a population approach. Multiple elements were identified within these priorities, all of which are important to ensuring successful and sustained integration of care. These included education, efficiency, patient centredness, safety, trust and time.Originality/valueThe study's findings bring clarity and definition to what has become an increasingly extensive and wide-ranging body of work on the topic of IC. Future research should evaluate the implementation of these priorities in care settings.

Patient Pathways During Acute in-Hospital Stroke Treatment: A Qualitative Multi-Method Study

“…Instead, it seems that the areas of acute stroke research vs. integrated (chronic) care have remained relatively separate. This is also visible in core literature on integrated care, including those reported in recent reviews, whose primary focus does not tend to focus on acute stroke or acute care more generally [ 25 70 71 72 73 74 75 ]. In this sense, our paper provides a useful case study on how these two fields can complement each other to provide comprehensive scientific insights as well as avenues for practice improvements.…”

Protocol for a mixed methods feasibility and implementation study of a community-based integrated care model for home-dwelling older adults: The INSPIRE project

“…To assess feasibility of the integrated care model, the current study incorporates key elements of implementation science such as measuring implementation processes and outcomes; using implementation strategies; and stakeholder involvement [58]. For example, given that integration processes are accepted as complex and fairly demanding on stakeholders and professionals [59], it is crucial to use strategies learnt from previous research such as building a multidisciplinary team culture, and shaping roles and competencies for integrated care [56].…”

Users’ and Providers’ Perceptions about Integrated Health Care in Southern Denmark

“…However, several informants perceived that connectivity did not exist; others perceived limited connectivity. Well-functioning connectivity (such as new ways of organizing) will enhance collective insight and learning [14].…”

“…Health care systems are increasingly complex, encompassing the provision of public health services, primary health care, secondary health care, and acute care in a variety of contexts [12][13][14]. The fragmentation of care occurs within and between providers, as well as at the interface between primary and secondary care, public health services, and health and social care [14]. Poor coordination results in duplication between health and social care services and unnecessary hospital stays, further increasing the financial burden on the system.…”