To read this content please select one of the options below:

Integrated ambulatory care in the New Zealand health system: a scoping review

Gagan Gurung (Department of General Practice and Rural Health, Otago Medical School, University of Otago, Dunedin, New Zealand) (Centre for Health Systems and Technology, University of Otago, Dunedin, New Zealand)
Carol Atmore (Department of General Practice and Rural Health, Otago Medical School, University of Otago, Dunedin, New Zealand) (Centre for Health Systems and Technology, University of Otago, Dunedin, New Zealand)
Robin Gauld (Dean's Office, Otago Business School, University of Otago, Dunedin, New Zealand) (Centre for Health Systems and Technology, University of Otago, Dunedin, New Zealand)
Tim Stokes (Department of General Practice and Rural Health, Otago Medical School, University of Otago, Dunedin, New Zealand) (Centre for Health Systems and Technology, University of Otago, Dunedin, New Zealand)

Journal of Integrated Care

ISSN: 1476-9018

Article publication date: 20 May 2020

Issue publication date: 22 July 2020

249

Abstract

Purpose

The purpose of this paper is to identify and describe the international and New Zealand (NZ) evidence for models of integrated ambulatory care and describe key implementation issues and lessons learnt.

Design/methodology/approach

A scoping review was conducted for published and grey literature on integrated care. Publications from 2000 to February 2019 that described integrated ambulatory care were included.

Findings

A total of 34 articles were included. Internationally and in NZ, the most common models of integrated care found were: transfer, relocation and joint working. The international literature showed that transferring care from hospitals to community and other integrated models of care between the primary–specialist interface increased access and convenience for patients. However, there was insufficient evidence of clinical and economic outcomes. Very few NZ-based studies reported on effectiveness of models of care. Key implementation issues were: no viable and sustainable funding, lack of infrastructure, lack of confidence, trust and communication between providers, increased workload and time and knowledge and skills gap to perform new roles. The NZ literature highlighted the need for an appropriate location for services, committed leadership, development of a governance group representing different provider groups, strong communication mechanisms, new workforce skills and overall change management.

Originality/value

The review provides an overview of key components of integrated care models in ambulatory settings and identifies some common elements across the models of care. The findings can inform the design and implementation of integrated ambulatory care in health systems.

Keywords

Acknowledgements

This project was funded by the Southern District Health Board (DHB), Otago and Southland, NZ. We are particularly grateful to Lisa Gestro, Executive Director Strategy, Primary and Community, Southern DHB for her support. The views expressed in this paper are those of the author(s) and not necessarily those of the Southern DHB.

Citation

Gurung, G., Atmore, C., Gauld, R. and Stokes, T. (2020), "Integrated ambulatory care in the New Zealand health system: a scoping review", Journal of Integrated Care, Vol. 28 No. 3, pp. 253-280. https://doi.org/10.1108/JICA-01-2020-0003

Publisher

:

Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

Related articles