Collective case study: integrated health and social care for older adults within a Canadian context

Abstract

PurposeCanada's population is aging and there are concerns that the welfare system may not support the increased demands on it. Integrated health and social care (IHSC) produces positive health and system outcomes but it needs to be better understood within a Canadian context. The purpose of this collective case study of three IHSC initiatives in Alberta, Ontario and Nova Scotia was to determine the factors that support successful services integration among different healthcare and social services organizations serving older adults within a Canadian context.Design/methodology/approachThis study used the Cheng and Catallo (2020) IHSC conceptual framework (CF) to guide the research. Primary data were based on key informant interviews of representatives from organizations that comprised each case and focus groups. A cross-case analysis was undertaken to determine common themes.FindingsThe cross-case analysis revealed that the three cases shared common integration and external influence factors based on the Cheng and Catallo (2020) CF. Some new factors were identified.Originality/valueThe study revealed that the Canadian context was important in influencing integration in the three cases and that there is a unique Canadian aspect to IHSC. The study offers up practical insights for government leaders and service administrators to improve IHSC for older adults. The study also identifies how the Cheng and Catallo (2020) IHSC CF can be enhanced and points to research opportunities to test the framework.

Healthy at Home: an integrated health and social care initiative for vulnerable and marginalized older adults in Toronto

“…To conclude, H@H case is fascinating because it lends insights into how IHSC can be leveraged to provide culturally appropriate care that is trauma-informed for highly vulnerable client/patient populations with leadership from social care agencies. The Cheng and Catallo (2023) conceptual model used to frame the case description was helpful in highlighting the importance of context in shaping integration at the local level and can be considered a valuable analysis tool.…”

“…It can result in improved health outcomes, minimizes acute care utilization, supports AIP and enhances access to services and identifying unmet needs (Suter et al ., 2007). However, IHSC is not well understood in Canada and is an evolving phenomenon in Canada (Cheng and Catallo, 2023). Care for immigrant older adult populations can be complex given their increased risk to poor health, and IHSC can be leveraged to support enhanced care from a more culturally responsive perspective (Cordes, 2021; Lewis and Myhra, 2018; Lu et al ., 2020).…”

“…A case description of an IHSC initiative, Healthy At Home (H@H), was undertaken for exploratory purposes to understand how a diverse group of health and social care organizations engaged in IHSC from a culturally appropriate stance for Jewish Russian-speaking older adult immigrants. This case was one of three cases that comprised the collective case by Cheng and Catallo (2023) that sought to explore integrated care within a Canadian context. The Cheng and Catallo (2023) study sought to answer the research question: what are the unique inter-organizational and contextual factors that enabled culturally appropriate IHSC?…”

“…This case was one of three cases that comprised the collective case by Cheng and Catallo (2023) that sought to explore integrated care within a Canadian context. The Cheng and Catallo (2023) study sought to answer the research question: what are the unique inter-organizational and contextual factors that enabled culturally appropriate IHSC?…”