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1 – 10 of over 72000
Article
Publication date: 1 October 2005

J Billings

It is suggested that a common understanding of integrated care between multi‐professional staff is vital to prevent barriers to unification and quality of care. This paper…

Abstract

It is suggested that a common understanding of integrated care between multi‐professional staff is vital to prevent barriers to unification and quality of care. This paper examines qualitative data from PROCARE, a recently completed European project on integrated care for older people, to put forward an interpretation of what integrated care means to staff. Through thematic analysis, four main clusters were identified. The paper suggests that, while the analysis revealed a common and inter‐related European interpretation that was somewhat idealised and moralistic, this was countered by challenges to its implementation that were inseparable from the rhetoric. The paper suggests that a collective, morally strong understanding is unable to prevent barriers to integrated care, and that tensions between services remain a prominent impediment.

Details

Journal of Integrated Care, vol. 13 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 28 November 2012

Derek Birrell and Deirdre Heenan

This paper assesses the recommendations and proposals contained in Transforming Your Care, the recent review of health and social care in Northern Ireland, in the context of the…

288

Abstract

Purpose

This paper assesses the recommendations and proposals contained in Transforming Your Care, the recent review of health and social care in Northern Ireland, in the context of the existing integrated structures. It is designed to promote a better understanding of the implications of the proposed reconfiguration of health and social care.

Design/methodology/approach

This paper reviews a number of published documents encompassing an independent review and subsequent plans and strategies. It also draws upon a case study of a Rapid Access Clinic undertaken by the authors as part of a wider research project.

Findings

The paper concludes that the planned changes question the ability of an integrated structure operating across primary, secondary and social care. It notes that there are real concerns about the capacity of the social care workforce to deliver services. It is suggested that the proposal for Integrated Care Partnerships can be seen as a reflection of the need for a more localised approach to delivery.

Research limitations/implications

The findings are derived from a small‐scale study and as such may make generalisation difficult. There is a clear need for a more robust evidence‐based approach to the evaluation of structural integration in health and social care and a process for monitoring of this change process.

Originality/value

The article is a reminder of the unique example of structural integration within the UK. As such it could have important lessons for England, Scotland and Wales which are moving in a similar direction.

Details

Journal of Integrated Care, vol. 20 no. 6
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 February 2004

J. Billings, A. Alaszewski and K. Coxon

This paper provides a European overview of alternative approaches to integrated care for older people, drawing from a wider European project entitled PROCARE. It discusses the…

Abstract

This paper provides a European overview of alternative approaches to integrated care for older people, drawing from a wider European project entitled PROCARE. It discusses the structural complexities that create the challenges in integrated care, compares and contrasts approaches to integrated care through a structure and process framework, and considers the place of person‐centred seamless care in European health and social care models.

Details

Journal of Integrated Care, vol. 12 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Book part
Publication date: 11 August 2014

Jenna M. Evans, Ross G. Baker, Whitney Berta and Barnsley Jan

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…

Abstract

Purpose

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.

Methods

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.

Findings

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).

Originality/value

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

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
ISBN: 978-1-78350-715-3

Keywords

Open Access
Article
Publication date: 4 August 2022

Q. Jane Zhao, Nathan Cupido, Cynthia R. Whitehead and Maria Mylopoulos

Design, implementation, and evaluation are all important for integrated care. However, they miss one critical factor: education. The authors define “integrated care education” as…

1479

Abstract

Purpose

Design, implementation, and evaluation are all important for integrated care. However, they miss one critical factor: education. The authors define “integrated care education” as meaningful learning that purposefully supports collaboration and the development of adaptive expertise in integrated care. The ECHO (Extensions for Community Health Outcomes) model is a novel digital health solution that uses technology-enabled learning (TEL) to facilitate, support, and model integrated care education. Using ECHO Concussion as a case study, the authors describe the effects of technology-enabled integrated care education on the micro-, meso-, and macro-dimensions of integrated care.

Design/methodology/approach

This case study was constructed using data extracted from ECHO Concussion from video-archived sessions, participant observation, and internal program evaluation memos. The research team met regularly to discuss the development of relevant themes to the dimensions of integrated care.

Findings

On the micro-level, clinical integration occurs through case-based learning and the development of adaptive expertise. On the meso-level, professional integration is achieved through the development of the “specialist generalist,” professional networks and empathy. Finally, on the macro-level, ECHO Concussion and the ECHO model achieve vertical and horizontal system integration in the delivery of integrated care. Vertical integration is achieved through ECHO by educating and connecting providers across sectors from primary to quaternary levels of care. Horizontal integration is achieved through the establishment of lateral peer-based networks across sectors as a result of participation in ECHO sessions with a focus on population-level health.

Originality/value

This case study examines the role of education in the delivery of integrated care through one program, ECHO Concussion. Using the three dimensions of integrated care on the micro-, meso-, and macro-levels, this case study is the first explicit operationalization of ECHO as a means of delivering integrated care education and supporting integrated care delivery.

Details

Journal of Integrated Care, vol. 30 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 14 March 2023

Gabriela Uribe, Ferdinand Mukumbang, Corey Moore, Tabitha Jones, Susan Woolfenden, Katarina Ostojic, Paul Haber, John Eastwood, James Gillespie and Carmen Huckel Schneider

Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is…

1282

Abstract

Purpose

Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is “health care”; however, the “social care” definition remains less explored. The authors describe the state of “social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives.

Design/methodology/approach

A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted.

Findings

In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: “social care as community outreach dialogues”, “social care as addressing an ageing population”, “social care as targeting multimorbidity and corresponding social risks factors” and “social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships; 27 studies reported having health and social care staff with clear integrated governance; 17 had dedicated funding and 11 used data-sharing and the integration of systems’ records.

Originality/value

The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations.

Details

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 12 October 2018

Lai Meng Ow Yong and Ailsa Cameron

The purpose of this paper is to document the influence of policy transfer on integrated care development, its global occurrence and shifts towards integrated care. It highlights…

Abstract

Purpose

The purpose of this paper is to document the influence of policy transfer on integrated care development, its global occurrence and shifts towards integrated care. It highlights the influence of supranational forces, and the roles and relevance of policy transfer and policy translation in the development of integrated care.

Design/methodology/approach

This paper presents the findings of an international review of the policy transfer of integrated care, and the relevance of policy translation in integrated care development.

Findings

The global occurrence in integrated care, as evinced in this paper, can be seen in the global shift towards integrated care in various countries. However, studies exploring the actual mechanism of policy transfer and policy translation in relation to integrated care across countries are limited. The study of integrated care through the lens of policy transfer is important, as it for example, explores the structural elements, including environmental and cognitive obstacles in the policy transfer process. Policy translation offers a social constructivist approach to explore the travel of ideas, and considers the multiple spatial and scalar contexts in which integrated care policy is implemented.

Originality/value

This paper aims to advance policy transfer and policy translation as complementary frameworks to explain integrated care development. Second, it seeks to make novel and useful contributions to the debate about the development of integrated care, and to the wider arguments on policy transfer and policy translation and integrated care in other parts of the world.

Details

Journal of Integrated Care, vol. 27 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 June 2000

Aggie Paulus, Arno van Raak, Frits van Merode and Eddy Adang

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…

1285

Abstract

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.

Details

Journal of Economic Studies, vol. 27 no. 3
Type: Research Article
ISSN: 0144-3585

Keywords

Article
Publication date: 26 June 2019

Siu Mee Cheng and Cristina Catallo

The purpose of this paper is to develop a case definition of integrated health and social services initiatives that serve older adults, and will provide characteristics to aid in…

Abstract

Purpose

The purpose of this paper is to develop a case definition of integrated health and social services initiatives that serve older adults, and will provide characteristics to aid in the identification of such initiatives. The case definition is intended to ease the identification of integrated health and social care initiatives.

Design/methodology/approach

A limited search was undertaken of both scientific and gray literature that documented and/or examined integrated health and social services initiatives. In addition, literature on well-documented and generally accepted integrated healthcare and social services models that reflect collaborations from healthcare and social services organizations that support older adults was also used to develop the case definition.

Findings

The case definition is as follows: healthcare organizations from across the continuum of care working together with social services organizations, so that services are complementary and coordinated in a seamless and unified system, with care continuity for the patient/client in order to achieve desired health outcomes within a holistic perspective; the initiatives comprise at least one healthcare organization and one social care organization; and these initiatives possess 18 characteristics, grouped under 9 themes: patient care approach; program goals; measurement; service and care quality; accountability and responsibility; information sharing; culture; leadership; and staff and professional interaction.

Research limitations/implications

A limitation of this study is that the characteristics are based on a limited literature search. The quality of some of the literature both gray and published was not definitive: information on how they undertook the literature search was not provided; exclusion and inclusion criteria were not included; and there was insufficient detail on the design of the studies included. Furthermore, the literature reviews are based on integrated initiatives that target both seniors and non-senior’s based services. The cross-section of initiatives studied is also different in scale and type, and these differences were not explored.

Practical implications

The case definition is a useful tool in aiding to further the understanding of integrated health and social care initiatives. The number of definitions that exist for integrated health and social care initiatives can make it confusing to clearly understand this field and topic. The characteristics identified can assist in providing greater clarity and understanding on health and social care integration.

Originality/value

This study provides greater coherence in the literature on health and social care integration. It aids in better framing the phenomenon of healthcare and social services integration, thereby enhancing understanding. Finally, the study provides a very useful and concrete list of identifying characteristics, to aid in identifying integrated health and social care initiatives that serve older adults.

Details

Journal of Integrated Care, vol. 27 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 28 November 2012

Mirella M.N. Minkman

Although a large amount of literature about the levels, aims, and relevance of integrated care is present, to realise change in practice knowledge about the implementation and…

1185

Abstract

Purpose

Although a large amount of literature about the levels, aims, and relevance of integrated care is present, to realise change in practice knowledge about the implementation and development process of integrated care is also crucial. Instruments such as quality management models can facilitate improvement, but are not frequently used in integrated care practice. The purpose of this paper, therefore, is to present further insight into these models and into the related literature about network and organisational development.

Design/methodology/approach

An overview of the recent literature is presented.

Findings

The improvement of integrated care is complex and there is no consensus about a set of relevant elements for integrated care. Available quality management models vary in their underlying evidence and do not have integrated care as their central focus or are aimed at specific patient groups such as the chronically ill. The lack of a consistent set of elements and the need for a generic, evidence‐based quality management model for integrated care is important for integrated care improvement. It can be assumed that, as described in the literature about networks and organisations, dynamic stages or phases could be relevant for integrated care. These issues raise important next questions for further research and for facilitating organisational change.

Originality/value

The paper presents a current overview of the available literature about the concept of integrated care, with a special focus on integrated care improvement and its dynamics. It raises the relevant questions and challenges for the further expansion of knowledge about these topics, which will be addressed in a second article in a later issue of Journal of Integrated Care.

Details

Journal of Integrated Care, vol. 20 no. 6
Type: Research Article
ISSN: 1476-9018

Keywords

1 – 10 of over 72000