Integrated Care: A Pill for All Ills?

There is an increasing policy emphasis on the integration of care, both within the healthcare sector and also between the health and social care sectors, with the simple aim of ensuring that individuals get the right care, in the right place, at the right time. However, implementin this simple aim si rather more complex. In this editorial, they seek to make sense of this complexity and ask: what does integrated care mean in practice? What are the mechanims by which it is expected to achieve its aim? And what is the nature of the evidence base around the outcomes delivered?

The Digital House of Care: Information solutions for integrated care

This paper draws on the recent experience of achieving large-scale data integration accross the boundaries of health and social care, to help plan and commission services more effectively. The purpose is to describe the development of a digital tool in an English county stiving towards a vision of integrated information that is used to underpin and increasingly integrated future of health and social care delivery. 

Integrated Diabetes Care: A Multidisciplinary Approach

Integrated care is an approach that seeks to improve the quality of care for people with diabetes by ensuring that services are well coordinated around their needs. Healthcare professionals, people with diabetes and the system must be aligned to support improvement both in the delivery of care and in achieving better outcomes for people with diabetes.

People-centred integration in a refugee primary care service: A complex adaptive systems perspective

Services for refugees and asylum seekers frequently experience gaps in delivery and access, poor coordination, and service stress. The purpose of this paper is to examine the approach to integrated care within Companion House (CH), a refugee primary care service, whose service mix includes counselling, medical care, community development, and advocacy. CH has created fluid links between teams, and encouraged open dialogue with client populations. There is a high level of networking between staff, much of it informal. This is underpinned by horizontal management and staff commitment to a shared mission and an ethos of mutual respect. The clinical teams ...

Intruments measuring integrated care: A systematic review of measurement properties

Integrated care is an important strategy for increasing health system preformance. Despite its growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague an limited. This systematic review found 209 index instruments measuring different constructs related to integrated care which suggest that the quality of measurement properties of instruments measuring integrate care is in need of improvement with the less-studied constructs and domains to become part of newly developed instruments. 

Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators

With an ageing population there is a move towards the use of assisted living technologies (ALTs) to provide social care and health care services, and to improve service processes. These technologies are at the forefront of the integration of health and social care. However, economic evaluatios of ALTs, and indeed economic evaluations of any interventions providing both health benefits and benefits beyond health are complex. This paper considers the challenges faced by evaluators and presents a method of economic evaluation for use with interventions where traditional methods may not be suitable for informing funders and decision makers. They propose a ...

What can a participatory approach to evaluation contribute to the field of integrated care?

Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground.

We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits ...

Integrated care for patients and populations: Improving outcomes by working together

This report examines:

- The case for integrated care

- What current barriers to integrated care need to be overcome and how

- What the Department of Health can do to provide a supporting framework to enable integrated care to flourish

- Options for a practical and technical support to those implementing integrated care, including approaches to evaluatin its impact 

The report asserts that developing integrated care should assume the same priority over the nect decade as reducing waiting times had during the last. The report makes a constructive contribution to the debate about integrated care and will be of interest to policy-makers, health ...

From vision to action. Making patient-centred care a reality

The NHS have worked with The King´s Fund to translate their themes into outcomes for patients and set out the most important priorities for action to achieve these outcomes. Under each of their five themes: 

- Co-ordinated care

- Patients engaged decisions about their care

- Supported self-management

- Prevention, early diagnosis and intervention

- Emotional, psychological and practical support

they have described the outcomes that they most want to achieve for patients. In order to achieve these outcomes, they hace then selected the service improvements that, if met, will have a major impact on the quality and cost-effectiveness of care. 

Understanding the role of community hospitals: an analysis of experiences in five countries

A policy focus on moving heathcare closer to people´s homes has led to renewed interest in community hospitals and their potential role in delivering more integrated care at local level, but models and approaches differ across countries. 

This study explores the policy drivers behind the implementation or advancement of these models; their function and role within the wider system of service provision; and the degree to which community hospitals contribute to enhanced integration of service delivery and benefit the population.