Evaluating integrated health care: a model for measurement

Abstract

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.

The Art of Integrating Care: Theories Revisited

“…teamwork and networks; see for example Gray [15] [18]. Moreover, models have been validated for the assessment of integrated care performance [19][20][21], and development determinants, like for instance the need of mutual trust and professional dedication, have been distinguished [22][23][24]. Such diverse focus of research implies applications of theories from various scientific domains, for instance, social, behavioural, and natural science.…”

“…In some cases it is necessary to merge, while in other cases integration can be limited to loosely contacts between providers of services. These theories were adapted by Ahgren & Axelsson into a continuum of integration to be used in a clinical context: starting with full segregation followed by linkage, coordination, co-operation, and ending up with full integration [21]. Full segregation represents the absence of any form of contacts between providers of health care.…”

Inter-agency work in Open Dialogue: the significance of listening and authenticity

“…A reference group was involved, representing the various organizations involved and helping to work out a referral process and case navigation that was adjusted to PJD. The reference group has helped to increase the agencies' ability to share goals and joint decision-making and thus enhance the integration between the various services (Ahgren & Axelsson, 2005;Horwath & Morrison, 2007). The impression was that the involved agencies showed great loyalty to the project.…”

Using Social Innovation as a Theoretical Framework to Guide Future Thinking on Facilitating Collaboration Between Mental Health and Criminal Justice Services

“…Evaluations specifically of the quality and quantity of collaboration and cocreation activity between professionals or services are largely absent. The actual and optimum level of structural integration between the mental health and criminal justice systems remains unmeasured although Ahgren & Axelsson, (2005) Community Treatment model. These are community based and integrate housing, employment, education and health support for individuals with co-occurring mental health, substance abuse disorders, homelessness and incarceration histories.…”