Measuring integrated care at the interface between primary care and secondary care: a scoping review

Abstract

PurposeIn many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of disease. The interface between primary and secondary care has been identified as a problem area. This paper aims to undertake a scoping review to gain a deeper understanding of the markers of integration across the primary–secondary interface.Design/methodology/approachA search was conducted of PubMed, SCOPUS, Cochrane Library and the grey literature for papers published in English using the framework described by Arksey and O'Malley. The search process was guided by the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA).FindingsThe initial database search identified 112 articles, which were screened by title and abstract. A total of 26 articles were selected for full-text review, after which nine articles were excluded as they were not relevant to the research question or the full text was not available. In total, 17 studies were included in the review. A range of study designs were identified including a systematic review (n = 3), mixed methods study (n = 5), qualitative (n = 6) and quantitative (n = 3). The included studies documented integration across the primary–secondary interface; integration measurement and factors affecting care coordination.Originality/valueMany studies examine individual aspects of integration. However, this study is unique as it provides a comprehensive overview of the many perspectives and methodological approaches involved with evaluating integration within the primary–secondary care interface and primary care itself. Further research is required to establish valid reliable tools for measurement and implementation.

Priorities in integrating primary and secondary care: a multimethod study of GPs

“…Meanwhile, the proposed causes of fragmentation within Ireland’s care system (e.g. communication and resource issues) largely resemble those cited in previous research (O’Farrell et al. , 2021; Kozlowska et al.…”

“…, 2018), inadequate referral pathways (O’Dowd et al. , 2017) and a lack of integrated care evaluation practices (O’Farrell et al. , 2021).…”

“…The World Health Organisation (WHO) meanwhile defines integrated care as an “organisation and management of health services”, one which aims to provide people with “the care they need, when they need it”, and in ways that are “user-friendly” and that “achieve the desired results and provide value for money” (Waddington and Egger, 2008). Evidence concerning the benefits of healthcare integration is mixed and integrated care outcomes are the focus of much ongoing study (O’Farrell et al. , 2021).…”

“…However, integrating primary and secondary care services can be particularly challenging. Research shows that primary-secondary care integration is negatively affected by various issues, including poor communication between care providers (Darker, 2013;O'Dowd et al, 2017;Kozlowska et al, 2018), inadequate referral pathways (O'Dowd et al, 2017) and a lack of integrated care evaluation practices (O'Farrell et al, 2021).…”

Chronic diseases in the context of integrated health and social care

“…1. Формирование междисциплинарной модели в рамках интерфейса первичной и вторичной медицинской помощи [13]. Преодоление фрагментарности в оказании медицинской помощи и формирование интегративного контента системы здравоохранения предполагает образование устойчивых связей и взаимовыгодного сотрудничества медицинских организаций и структурных единиц медицинской организации, что позволит повысить эффективность оказания медицинской помощи.…”