With the increasing differentiation of organisations involved in the pursuit of public health, there is also a growing need for inter-organisational integration. Starting from the concepts of differentiation and integration, this article is attempting a theoretical reconstruction based on published research on inter-organisational integration in public health and related welfare services. Different forms of integration are defined and related to each other in a conceptual framework, which is in itself an integration of different theoretical perspectives. According to this framework, integration in the field of public health requires inter-organisational collaboration across different sectors of the society. Such intersectoral collaboration can be organised mainly in the form of multidisciplinary teams across the boundaries of different organisations and sectors. Such an organisation is fragile and volatile, however, which means that it needs a lot of management support in order to survive.

Purpose: In the development of integrated care, there is an increasing need for knowledge about the actual degree of integration between different providers of health services. The purpose of this article is to describe the conceptualisation and validation of a practical model for measurement, which can be used by managers to implement and sustain integrated care. Theory:The model is based on a continuum of integration, extending from full segregation through intermediate forms of linkage, coordination and cooperation to full integration. Methods:The continuum was operationalised into a ratio scale of functional clinical integration. This scale was used in an explorative study of a local health authority in Sweden. Data on integration were collected in self-assessment forms together with estimated ranks of optimum integration between the different units of the health authority. The data were processed with statistical methods and the results were discussed with the managers concerned. Results:Judging from this explorative study, it seems that the model of measurement collects reliable and valid data of functional clinical integration in local health care. The model was also regarded as a useful instrument for managers of integrated care. Discussion:One of the main advantages with the model is that it includes optimum ranks of integration beside actual ranks. The optimum integration rank between two units is depending on the needs of both differentiation and integration.

Interprofessional collaboration has become more and more necessary in health and social care, mainly because of the increasing specialization of services and the increasing professionalization of different occupational groups. Most interprofessional collaboration is at the same time also interorganizational and it is taking place within a complicated structure, where collaborative teamwork is combined with hierarchical co-ordination and control in a sort of matrix organization. Based on the literature on organization, leadership and collaboration, this paper discusses territorial behaviour among professional groups and agencies as a difficult barrier to interprofessional collaboration. In order to overcome that barrier, the concept of altruism is explored as an alternative to territoriality. Professional altruism as well as altruistic leadership is discussed as a condition and a possibility for interprofessional collaboration. The discussion is illustrated with empirical data from a case study of collaboration in vocational rehabilitation.

Introduction: Collaboration between welfare organizations is an important strategy for integrating different health and welfare services. This article reports a review of the international literature on vocational rehabilitation, focusing on different organizational models of collaboration as well as different barriers and facilitating factors.