Unraveling the concept of Integrated Care

Abstract

Abstract:Purpose: To systematically study scientific articles that provide a description and/or a refinement of an integrated care model or program, and to identify the relations between objects and components in a taxonomy of integrated care.Background: Although care for chronically ill patients requires a shift towards care that is well coordinated and focused on prevention and self-care, the concept of 'integrated care' lacks specificity and clarity. Based on well-known models, this article initiates a taxonomy that is systematically filled up with literature to unravel the concept of integrated care. Methods:A systematic literature review on models describing integrated care was performed. Data were extracted related to the object and components of integration which are the basis of the taxonomy. Usefulness of the taxonomy was explored in interviews with health care insurers in the Netherlands. Results:The 34 studies that met the inclusion criteria presented specifications of four objects of integration (functional, organizational, professional and service). Components (focus, degree, patient centeredness and normative aspects) described the characteristics of these objects. The health care insurers confirmed the benefits of the taxonomy, yet signified the volatility of daily practice as well. Conclusions:The concepts described present a clarification of integrated care, which may be used as starting point for the development and refinement of models of integrated care with a stronger methodological grounding. Especially, since most studies assessed in this review lacked both empirical data and a description of the methods used.