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To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international academic research and literature.

A search of the health sciences literature was conducted using PubMed and EMBASE. A total of 114 articles were identified for inclusion and thematically analyzed using a strategy content model for systems-level integration.

Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution-centered models of integration to a broader focus on community-based health and social services; (3) from economic arguments for integration to an emphasis on improving quality of care and creating value; (4) from evaluations of integration using an organizational perspective to an emerging interest in patient-centered measures; (5) from a focus on modifying organizational and environmental structures to an emphasis on changing ways of working and influencing underlying cultural attitudes and norms; and (6) from integration for all patients within defined regions to a strategic focus on integrating care for specific populations. We propose that underlying many of these shifts is a growing recognition of the value of understanding health care delivery and integration as processes situated in Complex-Adaptive Systems (CAS).

This review builds a descriptive framework against which to assess, compare, and track integration strategies over time.

Integrated health care lacks a theoretical concept of the user figure that is appropriate to reflect users’ various claims and multi-dimensional interrelations in the care process. The paper aims to discuss this issue.

Key goals of integrated health care, such as a continuity of care, seamless services and better health outcomes depend strongly on users’ capabilities to engage themselves in the care process. These goals are hardly reachable if integrated health care schemes operate with a one-dimensional understanding of users’ identity.

The suggested concept of users’ identity facets suggests that users draw from different sources while receiving integrated health care. Thus, users are patients, co-producers, citizens, consumers and community members in one person and at the same time. Each facet of the user identity gains or loses relevance depending on health care contexts, health statuses, personal values and the design of service arrangements. As demonstrated by the example of disease management programmes (DMPs), care schemes for chronically ill persons, users have to apply different facets of their identities in order to benefit best from service provision. Moreover, addressing users’ identity may facilitate the extent of integration in DMPs.

Integrated health care schemes are challenged to invent strategies that facilitate and support coherence among users’ diverse identities in the process of service provision. Lessons could be learned from small-scale and localized integrated health care networks.

The purpose of this paper is twofold. First, to examine the impact on mental health social work of integrated care; and second, to explore the effectiveness of the use of deliberative research, a methodology which is new to mental health social work research.

Developed to enable examination of policy, deliberative research is underpinned by a desire to permit choice and change brought about through an iterative dialogue. This communication is based on informed and respectful equality between policy makers or implementers and those subject to that implementation. In order to achieve this equality, participation in debate by participants is viewed as essential, including as part of the process, participants becoming better informed about the phenomenon in question.

The findings show that effective mental health social work underpins successful integrated care which, in turn, is viewed as relevant. In addition, people who access services identified that mental health social workers are well positioned as facilitators and explainers in integrated care. The issue to be further explored by research, therefore, is not whether services should be delivered separately or in an integrated way, but how to keep improving and developing integrated care and especially the impact of ongoing power differentials.

The use of deliberative research worked reasonably well as an underpinning methodology for this study in that it sought to achieve the opinions of the public, in this instance consumers who provided or accessed mental health social work. The ethical need to ensure no harm came to this particular group meant that their opinions were not debated with the whole. This limitation to iterative dialogue is undoubtedly a consideration when undertaking deliberative research on such populations. This study offered just this, a one-off event, as in reality the commitment from participants to attend more than this one session would have been prohibitive.

The test, practically, comes with the events for data collection. This is not just the debate as to whether these, as one-off events, bring about agreement and not deliberation, but also whether researchers can, with a group that has particular needs, effectively integrate them into the deliberation. Given that it is an ethical priority to ensure that the participants are not harmed, this is not always going to be possible where the “public” includes those who may be vulnerable.

Deliberative research methodology is a new approach in mental health social work research. The influential finding is activism: people who access services recognise and suggest a challenge to the normative power differential in integrated care, as embodied in mental health social workers, and it is this aspect that warrants further investigation.

In many countries, health care reforms are being made with the purpose of stimulating actors to make economically sound decisions. Recent attempts in The Netherlands encompass the development and introduction of integrated health care arrangements. Since these arrangements are directly tailored to care demand, it is generally expected that integrated health care will enhance efficiency. This paper analyses whether a shift towards integrated health care actually represents a Pareto‐optimal change. An analysis of the consequences shows that care demanders, providers and informal care givers, to some extent and under certain conditions, can be expected to benefit from the introduction of integrated health care. Under long‐term considerations, the introduction of integrated care may be categorised as a potential Pareto‐improvement.

Theoretically, a health system has been described in terms of integration being the coordination of health services and collaboration amongst provider organizations. The components of an integrated health system remain inconclusive. Although senior healthcare executives establish structures and designs which facilitate the delivery of integrated care, their perspectives of a health system have not been explored. The purpose of this paper is to present senior healthcare executives’ perspectives of a health system which, when combined, form a model for developing an integrated health system.

Using a qualitative methodology and a multi-case study design, 11 presidents and 4 senior vice presidents of major healthcare organizations or systems in Ontario Canada were selected from a target population of 246 senior healthcare executives to engage in 1 h interviews each. Critical case sampling was applied in the selection of the study sample. Interviews were conducted between December 2017 and February 2018.

Senior healthcare executives expressed four distinct perspectives of a health system: systems, institutional, clinical and governance. When combined, the four perspectives form an original research-based concept or model for an integrated health system.

This paper conveys results of personal interviews with senior healthcare executives and presents a proposed model for an integrated health system based on their four distinct perspectives of a health system.

The problems that face health service delivery across different countries are compounded by financial, political, institutional and technical deficiencies. Yet, the role of technological aspects in the procurement of health commodities and health service delivery system requires in-depth exploration. This study bridges this gap by examining the mediating effect of an integrated health commodities procurement system on the relationship between responsiveness and health service delivery.

Data for this study were collected from 274 respondents, comprising procurement staff and pharmacists using a cross-sectional questionnaire survey. A total of 28 government-owned hospitals from 6 regions in the Southern Highland of Tanzania were sampled for observation. Confirmatory factor analysis (CFA) and structural equation modelling (SEM) were used for data analysis.

The results of the study revealed a positive and significant relationship between responsiveness and integrated health commodities procurement system (β = 0.572, p < 0.001). Responsiveness positively and significantly affects health service delivery (β = 0.175, p = 0.004). The results also show that integrated health commodities procurement system is positive and significantly related to health service delivery (β = 0.264, p < 0.001). Lastly, the bootstrapping confidence intervals revealed that an integrated health commodities procurement system significantly mediates the relationship between responsiveness and health service delivery.

To strengthen the health service delivery system, the study recommends enforcing internal control mechanisms and supporting policies that will monitor and evaluate the effectiveness of the integrated health commodities procurement system and service practitioners' responsiveness. Moreover, health service managers should ensure that the planning, procurement and distribution of health commodities are fully and effectively integrated at each node of the health supply chain.

The study contributes to the body of knowledge which examines the efficacy of health service delivery from procurement perspective. To the best of the author's knowledge, this is the first study that offers empirical evidence for the mediating effect of integrated health commodities procurement system on the link between responsiveness and health service delivery.

A survey of integrated working between primary care trusts (PCTs) and adult social services across England was undertaken in December 2009 and January 2010. The survey results are presented in the context of the history of integrated working between health and social care, and the recent policy announcements of the Conservative‐Liberal Democrat Coalition Government.

The purpose of this paper is to explore the evolving of integrated care, focussing on developments in why what matters to the patient matters and how to better understand the value the patient brings to and anticipates from integrated care.

A descriptive piece that draws on relevant research findings, literature, reports and health policy.

Although integrated care is a contemporary policy agenda, it is bringing back to the forefront the benefits of a population health planning approach. The shift in the health systems focus from inward looking to outward looking is promising, albeit has taken 25 years and is still evolving. Leadership is being demonstrated, however, a shared vision is elusive and not all voices are being heard. The development of a narrative that defines integrated care from the patient’s point of view is an important step. Next is better understanding the immediate and anticipatory public value integrated care offers.

This is a novel perspective of an enduring health reform policy concept. Currently the literature is thin.

Due to the need for the development of person-centred integrated models of care with a population health approach, this paper explored contemporary literature in this arena.

A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Papers included in this review focused upon person-centred integrated care and a health promotion/public health approach (January 2018–October 2020). Papers were excluded due to not being written in English, not fitting the age criteria and not being peer reviewed.

Eight studies met the inclusion criteria and three overarching themes were identified with regards to person-centred integrated care as a health promotion/public health approach: Core components; Development, implementation, and evaluation of models of care and relationship to population health and wellbeing outcomes.

The need for person-centred integrated care as a health promotion/public health approach, to enhance population health and well-being outcomes requires further research to continue to develop, implement and evaluate models of care.

The international scope of this contemporary review brought together the three concepts of person-centred integrated care and public health, exploring the translation of policy into practice (WHO, 2016). The juxtaposition of public health approaches in the background/consequential or foreground/active agent demonstrates how promotion, prevention and population health can be re-valued in integrated people-centred health services (WHO, 2016).

It seems impossible to create a comprehensive evaluation model which fully takes into account the multi‐dimensional context of integrated health and social care. Clinical integration, as a prerequisite for efficient outcomes of integration, must nonetheless get special attention. For more extensive evaluations, a quality chain matrix, including co‐operating acts by different providers, has proven to be useful. Examples of evaluated services in Sweden are given, and the management benefits of the use of evaluation data are highlighted.