Assessing the Effectiveness of Integrated Interventions: Terminology and Approach
Abstract
Integrated care is a term that embraces several concepts, all of which imply that the target patients have complex or chronic illness. There is an assumption that such patients require integrated care and benefit from it. Attempts to test this hypothesis have produced evidence of only modest benefit, and much of the evidence is conflicting. Demonstration of effectiveness of integrated interventions in the clinical setting has been less convincing. Often, interventions are introduced uncritically and without adequate follow-up of their effectiveness. More rigorous research is required on definitions, theoretic constructs,outcome measures, the science of data synthesis, and translation to the clinical setting. Recent developments in theoretic constructs in these areas give promise of better answers to the question, "What works for whom in what context?". Qualitative methodology should form part of this research.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Successful collaboration also relies on adequate systems and organisational supports.
“Successful collaboration also relies on adequate systems and organisational supports. 75”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [75]
Cites
Realist review - a new method of systematic review designed for complex policy interventions
Pawson, R., Greenhalgh, T., Harvey, G., & Walshe, K. (2005) · Journal of Health Services Research & Policy · doi:10.1258/1355819054308530 · Cited by 3,190 · see citing works
Kawamoto, K., Houlihan, C. A., Balas, E. A., & Lobach, D. F. (2005) · BMJ · doi:10.1136/bmj.38398.500764.8f · Cited by 2,703 · see citing works
Synthesising qualitative and quantitative evidence: A review of possible methods
Dixon-Woods, M., Agarwal, S., Jones, D., Young, B., & Sutton, A. (2005) · Journal of Health Services Research & Policy · doi:10.1177/135581960501000110 · Cited by 2,132 · see citing works
The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks
D'Amour, D., Ferrada-Videla, M., San Martin Rodriguez, L., & Beaulieu, M.-D. (2005) · Journal of Interprofessional Care · doi:10.1080/13561820500082529 · Cited by 1,456 · see citing works
Mood disorders in the medically ill: scientific review and recommendations
Evans, D. L., Charney, D. S., Lewis, L., Golden, R. N., Gorman, J. M., Krishnan, K. R. R., Nemeroff, C. B., Bremner, J. D., Carney, R. M., Coyne, J. C., et al. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2005.05.001 · Cited by 1,071 · see citing works
Bulger, R. E. (1992) · Kennedy Institute of Ethics journal · doi:10.1353/ken.0.0102 · Cited by 993 · see citing works
The determinants of successful collaboration: A review of theoretical and empirical studies
San Martín-Rodríguez, L., Beaulieu, M.-D., D'Amour, D., & Ferrada-Videla, M. (2005) · Journal of Interprofessional Care · doi:10.1080/13561820500082677 · Cited by 815 · see citing works
Weingarten, S. R. (2002) · BMJ · doi:10.1136/bmj.325.7370.925 · Cited by 735 · see citing works
Evidence-Based Quality Improvement: The State Of The Science
Shojania, K. G., & Grimshaw, J. (2005) · Health Affairs · doi:10.1377/hlthaff.24.1.138 · Cited by 684 · see citing works
Integrated care programmes for chronically ill patients: a review of systematic reviews
Ouwens, M. (2005) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzi016 · Cited by 606 · see citing works
Carlson, L. E., & Bultz, B. D. (2004) · Psycho-Oncology · doi:10.1002/pon.832 · Cited by 276 · see citing works
Statt, D. A. (1994) · doi:10.1007/978-1-349-23652-7_6 · Cited by 255 · see citing works
Treatment of Depression Improves Physical Functioning in Older Adults
Callahan, C. M., Kroenke, K., Counsell, S. R., Hendrie, H. C., Perkins, A. J., Katon, W. J., Noël, P. H., Harpole, L. H., Hunkeler, E. M., Unützer, J., et al. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53151.x · Cited by 204 · see citing works
Improving depression outcomes in older adults with comorbid medical illness
Harpole, L. H., Williams, J. W., Olsen, M. K., Stechuchak, K. M., Oddone, E. Ž., Callahan, C. M., Katon, W. J., Lin, E. H. B., Grypma, L., & Unützer, J. (2005) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2004.09.004 · Cited by 185 · see citing works
Zwarenstein, M., Reeves, S., & Perrier, L. (2005) · Journal of Interprofessional Care · doi:10.1080/13561820500082800 · Cited by 180 · see citing works
Improving Quality of Care Through Disease Management
Faxon, D. P., Schwamm, L. H., Pasternak, R. C., Peterson, E. D., McNeil, B. J., Bufalino, V. J., Yancy, C. W., Brass, L. M., Baker, D. W., Bonow, R. O., et al. (2004) · Circulation · doi:10.1161/01.cir.0000128373.90851.7b · Cited by 122 · see citing works
Impact of Robustness of Program Implementation on Outcomes of Clients in Dual Diagnosis Programs
Jerrell, J. M., & Ridgely, M. S. (1999) · Psychiatric Services · doi:10.1176/ps.50.1.109 · Cited by 86 · see citing works
Vanderplasschen, W., Rapp, R. C., Wolf, J., & Broekaert, E. (2004) · Psychiatric Services · doi:10.1176/appi.ps.55.8.913 · Cited by 74 · see citing works
The Institute of Medicine “Chasm” report: implications for depression collaborative care models
Katon, W. J. (2003) · General Hospital Psychiatry · doi:10.1016/s0163-8343(03)00064-1 · Cited by 73 · see citing works
Bravata, D. M., McDonald, K. M., Shojania, K. G., H, V. S. M. P., & Owens, D. K. (2005) · Annals of Internal Medicine · doi:10.7326/0003-4819-142-12_part_2-200506211-00005 · Cited by 59 · see citing works
The Diversity of Case Management Models
Huber, D. L. (2002) · Lippincott s Case Management · doi:10.1097/00129234-200211000-00002 · Cited by 49 · see citing works
Making health services management research critical: a review and a suggestion
Learmonth, M. (2003) · Sociology of Health & Illness · doi:10.1111/1467-9566.00326 · Cited by 46 · see citing works
Still no magic bullets: pursuing more rigorous research in quality improvement
Shojania, K. G., & Grimshaw, J. M. (2004) · The American Journal of Medicine · doi:10.1016/j.amjmed.2004.03.003 · Cited by 43 · see citing works
Mechanic, D. (2002) · Journal of Health Services Research & Policy · doi:10.1258/135581902320176359 · Cited by 29 · see citing works
The Future of Consultation–Liaison Psychiatry
Smith, G. C. (2003) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2003.01136.x · Cited by 29 · see citing works
Self-citationEvidence-based illiteracy: time to rescue “the literature”
O'Donnell, M. (2000) · The Lancet · doi:10.1016/s0140-6736(00)82040-1 · Cited by 28 · see citing works
George Engel's Contribution to Clinical Psychiatry
Smith, G. C., & Strain, J. J. (2002) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2002.t01-1-01036.x · Cited by 20 · see citing works
Self-citationConsultation-liaison: from dream to reality
Huyse, F. J., & Smith, G. C. (1997) · Psychiatric Bulletin · doi:10.1192/pb.21.9.529 · Cited by 7 · see citing works
Self-citationSmith, S., Allwright, S., & O’Dowd, T. C. (2004) · doi:10.1002/14651858.cd004910 · Cited by 6 · see citing works
Is clinical service development simply applied evidence-based medicine? A focus group study
Ruddy, R., & House, A. O. (2005) · Psychiatric Bulletin · doi:10.1192/pb.29.7.259 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline
Teede, H. J., Misso, M. L., Deeks, A. A., Moran, L. J., Stuckey, B. G. A., Wong, J. L. A., Norman, R. J., Costello, M. F., & Groups, O. B. O. T. G. D. (2011) · Medical Journal of Australia · doi:10.5694/mja11.10915 · Cited by 379 · see citing works
The SELFIE framework for integrated care for multi-morbidity: Development and description
Leijten, F., Struckmann, V., van Ginneken, E., Czypionka, T., Kraus, M., Reiss, M., Tsiachristas, A., Boland, M. R. S., Bont, A. A. D., Bal, R. A., et al. (2017) · Health Policy · doi:10.1016/j.healthpol.2017.06.002 · Cited by 263 · see citing works
Relevant models and elements of integrated care for multi-morbidity: Results of a scoping review
Struckmann, V., Leijten, F., van Ginneken, E., Kraus, M., Reiss, M., Spranger, A., Boland, M. R. S., Czypionka, T., Busse, R., & Mölken, M. R. (2017) · Health Policy · doi:10.1016/j.healthpol.2017.08.008 · Cited by 174 · see citing works
A quality management model for integrated care: results of a Delphi and Concept Mapping study
Minkman, M. M. N., Ahaus, K., Fabbricotti, I. N., Nabitz, U. W., & Huijsman, R. (2008) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzn048 · Cited by 127 · see citing works
Care Coordination of Multimorbidity: A Scoping Study
Døssing, A., & Burau, V. (2015) · Journal of Comorbidity · doi:10.15256/joc.2015.5.39 · Cited by 106 · see citing works
Minkman, M. M. N., Vermeulen, R. P., Ahaus, K., & Huijsman, R. (2011) · BMC Health Services Research · doi:10.1186/1472-6963-11-177 · Cited by 68 · see citing works
From Consultation–Liaison Psychiatry to Integrated Care for Multiple and Complex Needs
Smith, G. C. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802534358 · Cited by 57 · see citing works
Self-citationThe current state of integrated care: an overview
Minkman, M. M. N. (2012) · Journal of Integrated Care · doi:10.1108/14769011211285147 · Cited by 44 · see citing works
Challenges to the provision of specialized care in remote rural municipalities in Brazil
Nunes, F. G. D. S., dos Santos, A. M., Carneiro, Â. O., Fausto, M. C. R., Cabral, L. M. D. S., & de Almeida, P. F. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08805-6 · Cited by 24 · see citing works
Boak, J., Rasekaba, T. M., Baxter, P. E., & Blackberry, I. (2023) · Journal of Advanced Nursing · doi:10.1111/jan.15824 · Cited by 14 · see citing works
Best, S. (2017) · British Journal of Occupational Therapy · doi:10.1177/0308022616688019 · Cited by 7 · see citing works
ESTRATÉGIA SAÚDE DA FAMÍLIA E A INTEGRALIDADE DO CUIDADO: PERCEPÇÃO DOS PROFISSIONAIS
de Souza, A. P., Rezende, K. A., Marín, M. J. S., & Tonhom, S. F. D. R. (2020) · Revista Baiana de Enfermagem · doi:10.18471/rbe.v34.34935 · Cited by 5 · see citing works
Moreira, R. O., & Zen, M. S. (2007) · Brazilian Journal of Psychiatry · doi:10.1590/s1516-44462007000200020 · Cited by 4 · see citing works
Revisando conceitos: o papel da psiquiatria moderna no hospital geral e na atenção primária
Marco, M. A. D., Cítero, V. D. A., & Nogueira-Martins, L. A. (2007) · Brazilian Journal of Psychiatry · doi:10.1590/s1516-44462007000200019 · Cited by 4 · see citing works
Modelos de organização e gestão da atenção à saúde: redes locais, regionais e nacionais
Ouverney, A. M., & de Noronha, J. C. (2013) · Fiocruz/Ipea/Ministério da Saúde/Secretaria de Assuntos Estratégicos da Presidência da República eBooks · doi:10.7476/9788581100173.0006 · Cited by 4 · see citing works
Does competition support integrated care to improve quality?
Feng, C., Jianping, Z., Zhenjie, L., Wenxing, L., & Li, Y. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e24836 · Cited by 3 · see citing works
A saúde no Brasil em 2030: organização e gestão do sistema de saúde - Vol. 3
Cruz, F. O. (2013) · Fiocruz/Ipea/Ministério da Saúde/Secretaria de Assuntos Estratégicos da Presidência da República eBooks · doi:10.7476/9788581100173 · Cited by 3 · see citing works
Konsiliar- und Liaisondienste für psychische Störungen
Diefenbacher, A., Burian, R., Klesse, C., & Härter, M. C. (2012) · Elsevier eBooks · doi:10.1016/b978-3-437-22483-6.10029-4 · Cited by 3 · see citing works
Lobo, E., Rabanaque, M.-J., de Jonge, P., Barcones, M. F., Cazcarra, R., Huyse, F. J., & Lobo, A. (2008) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2008.04756.x · Cited by 2 · see citing works
The organization of psychiatric services for general hospital departments
Huyse, F. J., Kathol, R. G., Söllner, W., & Wulsin, L. R. (2012) · doi:10.1093/med/9780199696758.003.0148 · Cited by 1 · see citing works
Dementia Care in Nursing Homes Requires a Multidisciplinary Approach
Schols, J. M. G. A., & Kardol, T. (2017) · Springer eBooks · doi:10.1007/978-3-319-49832-4_15 · Cited by 1 · see citing works
Magno, E. D. S., Saraiva-Bonatto, E. C., & Saraiva, M. D. G. G. (2020) · doi:10.37421/jid.2020.4.120 · Cited by 1 · see citing works
Diefenbacher, A., Burian, R., Klesse, C., & Härter, M. C. (2009) · Elsevier eBooks · doi:10.1016/b978-343722481-2.50033-7 · Cited by 1 · see citing works
Geïntegreerde psychologische en multidisciplinaire zorg
Huyse, F. J. (2010) · Bijblijven · doi:10.1007/bf03088745
Marco, M. A. D., Albuquerque, V. D. M. M., & Nogueira-Martins, L. A. (2007)
A Brief Review on Infectious and Parasitic Diseases
Muthuirulan, P. (2020)
Nunes, F. G. D. S., dos Santos, A. M., Carneiro, Â. O., Fausto, M. C. R., Cabral, L. M. D. S., & de Almeida, P. F. (2022) · Research Square · doi:10.21203/rs.3.rs-1507418/v1
Geïntegreerde psychologische en multidisciplinaire zorg
Huyse, F. J. (2010) · Bijblijven · doi:10.1007/s12414-010-0016-1
Relación entre los médicos y pacientes en un hospital público
Camargo, W., & Farias, D. (2022) · Revista Acciones Médicas · doi:10.35622/j.ram.2022.03.006
Internists' interactions with chronically ill patients
Kromme, N. M. H. (2023) · doi:10.33612/diss.576013922
Boak, J., Rasekaba, T. M., & Blackberry, I. (2025) · Nursing Open · doi:10.1002/nop2.70245
- Authors
- Smith, G., & Clarke, D.
- Affiliations
- Monash Medical Centre (AU)
- Corresponding author
- Smith, Graeme
- Venue
- Medical Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2006-07
- Volume
- 90
- Issue
- 4
- Pages
- 533-548
- ISSN
- 0025-7125 (ISSN-L)
- OpenAlex
- W2162593386
- Cited by
- 32
- References
- 30
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2020: 3 · 2017: 4 · 2015: 1 · 2013: 2 · 2012: 3
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Keywords
- integrated care, integrated intervention, effectiveness evaluation, chronic disease, complex care, outcome measures, data synthesis, theory of change, clinical implementation, qualitative research, evidence-based practice
- MeSH terms
- Cooperative Behavior, Humans, Terminology as Topic, Patient Care Management, Social Behavior Disorders, Sociology, Medical, Diagnosis, Dual (Psychiatry), Delivery of Health Care, Integrated, Evidence-Based Medicine, Decision Support Systems, Clinical, Interdisciplinary Communication
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
