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All Together Now: A Conceptual Exploration of Integrated Care
Open accessAbstract
Integrated care is a key strategy in reforming health systems around the world. Despite its importance, the concept's polymorphous nature and lack of specificity and clarity significantly hamper systematic understanding, successful application and meaningful evaluation. This article explores the many definitions, concepts, logics and methods found in health system and service integration. In addition to framing this evolving, albeit imprecise field, the article summarizes the main elements or building blocks of integrated care and suggests a way to address its various complexities and unknowns in a real-world sense.
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“Common barriers such as the absence of healthcare policies and supporting strategies, inadequate interdisciplinary training and workload increase seem to depend on both contextual and individual factors rather than the discipline itself.”
From Barriers and facilitators in the integration of oral health into primary care: a scoping review (2017) · cites this paper as [78]
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“The results of the present scoping review are in line with publications on the challenges faced in the implementation of integrated care.”
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Dementia prevention, intervention, and care
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31363-6 · Cited by 6,072
Valentijn, P. P., Schepman, S. M., Opheij, W., & Bruijnzeels, M. A. (2013) · International Journal of Integrated Care · doi:10.5334/ijic.886 · Cited by 1,174
“However, the broad spectrum of organisations needed to assure good health in a population makes organisational integration complicated [5, 16].”
BackgroundInfluentialGoodwin, N. (2016) · International Journal of Integrated Care · doi:10.5334/ijic.2530 · Cited by 431
“It is often suggested that the strongest form is the ‘fully integrated’ model that is characterised by integrated teams working in an organisation with a single set of governance and accountability rules and common budgets and incentives [1].”
BackgroundIntegrated care programmes for adults with chronic conditions: a meta-review
Martínez-González, N. A., Berchtold, P., Ullman, K., Busato, A., & Egger, M. (2014) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzu071 · Cited by 253
Hughes, G., Shaw, S. E., & Greenhalgh, T. (2020) · Milbank Quarterly · doi:10.1111/1468-0009.12459 · Cited by 256
Elements of integrated care approaches for older people: a review of reviews
Briggs, A. M., Valentijn, P., Thiyagarajan, J. A., & de Carvalho, I. A. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-021194 · Cited by 230
Towards a taxonomy for integrated care: a mixed-methods study
Valentijn, P., Boesveld, I. C., van der Klauw, D. M., Ruwaard, D., Struijs, J. N., Molema, J. J. W., Bruijnzeels, M. A., & Vrijhoef, H. J. (2015) · International Journal of Integrated Care · doi:10.5334/ijic.1513 · Cited by 227
“In particular, the knowledge base is hampered by the lack of common terminology and typology regarding integrated care [2].”
InfluentialManderson, B., McMurray, J., Piraino, E., & Stolee, P. (2011) · Health & Social Care in the Community · doi:10.1111/j.1365-2524.2011.01032.x · Cited by 214
Values of Integrated Care: A Systematic Review
Zonneveld, N., Driessen, N., Stüssgen, R., & Minkman, M. M. N. (2018) · International Journal of Integrated Care · doi:10.5334/ijic.4172 · Cited by 206
“Considering that integrated care is practiced at multiple levels, some of the articles included in our analysis contain a distinction between different levels in the description of their findings [39, 56, 60, 62, 63].”
Barriers and facilitators in the integration of oral health into primary care: a scoping review
Harnagea, H., Couturier, Y., Shrivastava, R., Girard, F., Lamothe, L., Bedos, C. P., & Emami, E. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016078 · Cited by 179
Reframing the challenges to integrated care: a complex-adaptive systems perspective
Tsasis, P., Evans, J. M., & Owen, S. (2012) · International Journal of Integrated Care · doi:10.5334/ijic.843 · Cited by 172
“Multiple definitions and models of integrated care exist [13] ranging from the traditional, single ownership “integrated delivery system” [14] to more flexible arrangements based on partnership contracts [15].”
BackgroundEnablers and Barriers in Implementing Integrated Care
Maruthappu, M., Hasan, A., & Zeltner, T. B. (2015) · Health Systems & Reform · doi:10.1080/23288604.2015.1077301 · Cited by 153
“In case studies of integrated care, governments have adopted various roles, from leading change, funding, and implementing integrated care to having almost no involvement in care programs.(5,8,26) In the UK, the public sector has led an attempt to move the National Health Service toward integrated care in Northwest Lo…”
BackgroundeHealth and quality in health care: implementation time
Ossebaard, H. C., & Gemert-Pijnen, L. V. (2016) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzw032 · Cited by 148
A Prospective Validation Study of a Rainbow Model of Integrated Care Measurement Tool in Singapore
Vrijhoef, H. J. (2016) · International Journal of Integrated Care · doi:10.5334/ijic.2021 · Cited by 129
“Integrated care denotes different things for different people and has been used interchangeably with managed care in the United States of America, shared care in the United Kingdom, transmural care in the Netherlands and comprehensive care or disease management in other parts of the world [9].”
BackgroundTowards an international taxonomy of integrated primary care: a Delphi consensus approach
Valentijn, P., Vrijhoef, H. J., Ruwaard, D., Boesveld, I. C., Arends, R., & Bruijnzeels, M. A. (2015) · BMC Family Practice · doi:10.1186/s12875-015-0278-x · Cited by 138
“integrated care models lack a primary care perspective that is based on an encompassing inter-sectorial system approach with a distinct community and socio-political focus [3, 4].”
Analysis of case management programs for patients with dementia: A systematic review
Somme, D., Trouvé, H., Dramé, M., Gagnon, D., Couturier, Y., & Saint‐Jean, O. (2012) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2011.06.004 · Cited by 123
“Because these could both partly explain the impact of the programs reported, it would be interesting to have a common analysis framework of integrated care [19].”
BackgroundInfluentialImpact of Integrated Care on Patient-Related Outcomes Among Older People – A Systematic Review
Liljas, A. E. M., Brattström, F., Burström, B., Schön, P., & Agerholm, J. (2019) · International Journal of Integrated Care · doi:10.5334/ijic.4632 · Cited by 123
Health systems, communicable diseases and integration
Shigayeva, A., Atun, R. A., McKee, M., & Coker, R. (2010) · Health Policy and Planning · doi:10.1093/heapol/czq060 · Cited by 124
Looman, W. M., Huijsman, R., & Fabbricotti, I. N. (2018) · Health & Social Care in the Community · doi:10.1111/hsc.12571 · Cited by 116
“The assumption is that a higher level of integration leads to better outcomes (Kodner & Spreeuwenberg, 2002); however, it still remains unclear what specific bundles of integrated care lead to specific outcomes (Eklund & Wilhelmson, 2009; Kodner, 2009).”
BackgroundThe Evolution Of Integrated Health Care Strategies
Evans, J. M., BAKER, R. G., & Berta, W. B. (2013) · Advances in health care management · doi:10.1108/s1474-8231(2013)0000015011 · Cited by 106
“Increasingly, scholars call for the establishment of a common language and framework of integrated care to provide a base for advancing research and practice (Kodner, 2009; Stein & Rieder, 2009).”
BackgroundInstruments Measuring Integrated Care: A Systematic Review of Measurement Properties
Bautista, M. A., Nurjono, M., Lim, Y. W., Dessers, E., & Vrijhoef, H. J. (2016) · Milbank Quarterly · doi:10.1111/1468-0009.12233 · Cited by 105
“Mode of administration Face-to-face interview 40 (11) Tele-interview 20 (5) Self-administered (PAPI, postal) 235 (62) Self-administered (CAPI, electronic) 13 (3)”
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Abrahamson, V., Jensen, J., Springett, K., & Sakel, M. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2016.1211755 · Cited by 103
“However, over the past decade there has been little progress in the provision of integrated care and individually tailored long-term services for those with severe TBI in the community [26] despite the research focus on community reintegration,[27] continuity of care [28,29] and integrated care.[30,31] It is essential…”
BackgroundBarriers to addressing perinatal mental health issues in midwifery settings
Bayrampour, H., Hapsari, A. P., & Pavlovic, J. (2018) · Midwifery · doi:10.1016/j.midw.2017.12.020 · Cited by 121
Ong, S. E., Koh, J. J. K., Toh, S.-A. E. S., Chia, K. S., Balabanova, D., McKee, M., Perel, P., & Legido‐Quigley, H. (2018) · PLoS ONE · doi:10.1371/journal.pone.0195086 · Cited by 101
Towards Integrated Youth Care: A Systematic Review of Facilitators and Barriers for Professionals
Nooteboom, L. A., Mulder, E. A., Kuiper, C. H. Z., Colins, O. F., & Vermeiren, R. R. J. M. (2020) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-020-01049-8 · Cited by 96
“A common feature in models and terms is that integrated care seeks to improve quality of care for families by ensuring well-coordinated services around families’ needs by incorporating services, ensuring collaboration, and overcoming fragmentation (Kodner 2009; Wodchis et al.”
BackgroundInfluentialOrganizational Context and Capabilities for Integrating Care: A Framework for Improvement
Evans, J. M., Grudniewicz, A., Baker, G. R., & Wodchis, W. P. (2016) · International Journal of Integrated Care · doi:10.5334/ijic.2416 · Cited by 91
“ery involves multi-level changes to organizational structures, operational activities, and external relationships [1].”
BackgroundA Review of the Essential Components of Quality Palliative Care in the Home
Seow, H. Y., & Bainbridge, D. B. (2017) · Journal of Palliative Medicine · doi:10.1089/jpm.2017.0392 · Cited by 88
“33,46 Recommendations cannot be too rigid in terms of structures and processes.”
The narrative for person-centred coordinated care
Redding, D. (2013) · Journal of Integrated Care · doi:10.1108/jica-06-2013-0018 · Cited by 79
“Another (Kodner, 2009) concluded that “Integrated care as a concept is an imprecise hodgepodge”.”
BackgroundShared mental models of integrated care: aligning multiple stakeholder perspectives
Evans, J. M., & Baker, G. R. (2012) · Journal of Health Organization and Management · doi:10.1108/14777261211276989 · Cited by 89
“For example, while clinicians emphasize interdisciplinary teamwork and coordination of tasks, managers focus on developing combined funding streams, joint performance targets, and a shared culture (Kodner, 2009).”
BackgroundInfluentialA Scoping Review of Facilitators of Multi-Professional Collaboration in Primary Care
Sørensen, M., Stenberg, U., & Garnweidner-Holme, L. M. (2018) · International Journal of Integrated Care · doi:10.5334/ijic.3959 · Cited by 72
“Measures that enhance cooperation between national and local authorities in ways that improve the capability of municipalities to establish supportive relationships with HCPs is necessary to contain costs, improve the quality of care and offer more population-suitable care [74, 75].”
BackgroundIntegrated Care: A Pill for All Ills?
Goddard, M. K., & Mason, A. (2016) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2016.111 · Cited by 69
“International Journal of Health Policy and Management, 2017, 6(1), 1–3 2 of integrated care: in order to understand how it might achieve benefits and indeed, whether the benefits are realised, we need to keep sight of the general principles and the degree to which they are adhered to, whilst ensuring there is also cla…”
BackgroundInfluentialMinkman, 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
“Systematic reviews and studies of organizational interventions aimed at improving patient care have established that integrated care could improve care processes, patient outcomes and, although more inconclusive, reduce costs [3,17-20].”
BackgroundTransforming our health care system: ten priorities for commissioners
Imison, C. (2015) · Cited by 67
Realist evaluation of a complex integrated care programme: protocol for a mixed methods study
Nurjono, M., Shrestha, P., Lee, A., Lim, X. Y., Shiraz, F., Tan, S., Wong, S. H., Foo, K. M., Wee, T., Toh, S.-A. E. S., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-017111 · Cited by 66
Integrating health care in Australia: a qualitative evaluation
Trankle, S. A., Usherwood, T. P., Abbott, P., Roberts, M. M., Crampton, M., Girgis, C. M., Riskallah, J., Chang, Y., Saini, J., & Reath, J. (2019) · BMC Health Services Research · doi:10.1186/s12913-019-4780-z · Cited by 65
Integrating network theory into the study of integrated healthcare
Burns, L. R., Nembhard, I. M., & Shortell, S. M. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.114664 · Cited by 59
Carmont, S.-A. S., Mitchell, G. K., Senior, H., & Foster, M. M. (2017) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2016-001125 · Cited by 61
Instruments to assess integrated care: A systematic review
Lyngsø, A. M., Godtfredsen, N. S., Høst, D., & Frølich, A. (2014) · International Journal of Integrated Care · doi:10.5334/ijic.1184 · Cited by 60
“This increasing focus on integrated care as a means of improving the performance of health systems is widespread in Europe, North America and other parts of the world [2].”
BackgroundGeorgiou, A., Hyppönen, H., Ammenwerth, E., de Keizer, N. F., Magrabi, F., Scott, P., & Rigby, M. (2015) · Yearbook of Medical Informatics · doi:10.15265/iy-2015-007 · Cited by 66
“It also goes beyond simply linking individual components of treatment or care by integrating them into one holistic package with shared responsibility for delivery to an agreed pattern [3-5].”
BackgroundÖcek, Z. A., Çiçeklioğlu, M., Yücel, U., & Özdemir, R. (2014) · BMC Family Practice · doi:10.1186/1471-2296-15-38 · Cited by 59
Farmanova, E., Baker, G. R., & Cohen, D. J. (2019) · International Journal of Integrated Care · doi:10.5334/ijic.4197 · Cited by 59
“These inclusion criteria helped us identify examples of initiatives and programs designed with consideration of concepts of integrated care [15, 28] and tenets of the population health approach [21].”
BackgroundLooman, W. M., Fabbricotti, I. N., & Huijsman, R. (2014) · International Journal of Integrated Care · doi:10.5334/ijic.1010 · Cited by 58
“However, this growing body of evidence comes from studies that evaluated different integrated care models, including various components of integrated care [9,19].”
BackgroundInfluentialService Integration Across Sectors in Europe: Literature and Practice
van Duijn, S., Zonneveld, N., Montero, A. L., Minkman, M. M. N., & Nies, H. L. G. R. (2018) · International Journal of Integrated Care · doi:10.5334/ijic.3107 · Cited by 57
Common Components of Efficacious In‐Home End‐of‐Life Care Programs: A Review of Systematic Reviews
Bainbridge, D. B., Seow, H. Y., & SUSSMAN, J. S. (2016) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14025 · Cited by 55
Lloyd, H. M., Pearson, M., Sheaff, R., Asthana, S., Wheat, H. C., Sugavanam, T., Britten, N., Valderas, J. M., Bainbridge, M., Witts, L., et al. (2017) · Health Research Policy and Systems · doi:10.1186/s12961-017-0263-z · Cited by 54
Gage, H., Dickinson, A. M., Victor, C. R., Williams, P., Cheynel, J., Davies, S. L., Iliffe, S., Froggatt, K. A., Martin, W. E., & Goodman, C. M. (2012) · BMC Geriatrics · doi:10.1186/1471-2318-12-71 · Cited by 53
“The survey findings suggest that most collaboration between care homes and primary care services are linkages, fostered by good working relationships between care home staff and NHS professionals [26].”
BackgroundLyngsø, A. M., Godtfredsen, N., & Frølich, A. (2016) · International Journal of Integrated Care · doi:10.5334/ijic.2449 · Cited by 59
“Although these efforts have the desired impact in terms of clinical and organisational differentiation, they also engender fragmented care [5, 6].”
Backgroundder Eerden, M. D. H.-V., Csikós, Á., Busa, C., Hughes, S. P. F., Radbruch, L., Menten, J. J., Hasselaar, J. G. J., & Groot, M. M. (2014) · BMC Palliative Care · doi:10.1186/1472-684x-13-52 · Cited by 52
“These endeavours focus on the integration of palliative care either early in a certain disease trajectory and/or in the organisation of care, by collaboration and consultation with experienced (palliative) care services and specialists [14,15].”
BackgroundGrudniewicz, A., Tenbensel, T., Evans, J. M., Gray, C. S., Baker, G. R., & Wodchis, W. P. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2017.12.029 · Cited by 52
Nuti, S., Bini, B., Ruggieri, T. G., Piaggesi, A., & Ricci, L. (2016) · International Journal of Integrated Care · doi:10.5334/ijic.1991 · Cited by 51
“In terms of breadth, integration between different organizations is known as vertical integration and the coordination of similar units or settings of care as horizontal integration [3, 52].”
BackgroundFrom micro to macro: assessing implementation of integrated care in Australia
Angus, L., & Valentijn, P. (2017) · Australian Journal of Primary Health · doi:10.1071/py17024 · Cited by 51
van der Klauw, D., Molema, H., Grooten, L., & Vrijhoef, H. J. (2014) · International Journal of Integrated Care · doi:10.5334/ijic.1127 · Cited by 50
Wodskou, P. M., Høst, D., Godtfredsen, N. S., & Frølich, A. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-471 · Cited by 49
Harst, L., Timpel, P., Otto, L., Richter, P., Wollschlaeger, B., Winkler, K., & Schlieter, H. (2019) · Journal of Public Health · doi:10.1007/s10389-019-01065-5 · Cited by 48
“Integrated care as a promising concept for the handling of this transition process requires close collaboration, networking and alignment of several health or social service providers, patients and other stakeholders (Kodner 2009).”
BackgroundValentijn, P., Vrijhoef, H. J., Ruwaard, D., Bont, A. A. D., Arends, R., & Bruijnzeels, M. A. (2015) · BMC Health Services Research · doi:10.1186/s12913-014-0634-x · Cited by 48
“clients, professionals or policymakers) involved in an integrated primary care setting [2,7].”
BackgroundLooman, W. M., Fabbricotti, I. N., de Kuyper, R. D. M., & Huijsman, R. (2016) · BMC Geriatrics · doi:10.1186/s12877-016-0214-5 · Cited by 48
“Care is also fragmented and lacks continuity and coordination [7].”
BackgroundPower and Integrated Health Care: Shifting from Governance to Governmentality
van Rensburg, A. J., Rau, A., Fourie, P., & Bracke, P. (2016) · International Journal of Integrated Care · doi:10.5334/ijic.2480 · Cited by 47
“popular strategy to address fragmented and uncoordinated health systems [10], as well as to increase accessibility to care (especially of disadvantaged communities) [8, 11].”
BackgroundWhat are the principles that underpin integrated care?
Ferrer, L., & Goodwin, N. (2014) · International Journal of Integrated Care · doi:10.5334/ijic.1884 · Cited by 47
Quality indicators of integrated care for patients with head and neck cancer
van Overveld, L. F. J., Braspenning, J. C. C., & Hermens, R. (2016) · Clinical Otolaryngology · doi:10.1111/coa.12724 · Cited by 49
Wuest, J., Merritt‐Gray, M., Dubé, N., Hodgins, M. J., Malcolm, J., Majerovich, J. A., Scott‐Storey, K., Ford‐Gilboe, M., & Varcoe, C. (2015) · Research in Nursing & Health · doi:10.1002/nur.21636 · Cited by 46
“Although integrated care is key to health care reform, ways to bridge silos among health and other systems for better outcomes are poorly understood (Kodner, 2009).”
BackgroundReorganising health and social care in Québec: a journey towards integrating care through mergers
Wankah, P., Guillette, M., Dumas, S., Couturier, Y., Gagnon, D., Belzile, L., Mosbah, Y., & Breton, M. (2018) · London Journal of Primary Care · doi:10.1080/17571472.2018.1453957 · Cited by 46
“Community Oriented Integrated Care (COIC) is an organisational care delivery model that promotes inter-professional and inter-organisational collaborations, coordination and interdependence in delivering a comprehensive package of services to a specified population in a given territory [2,3].”
BackgroundValentijn, P., Pereira, F., Sterner, C. W., Vrijhoef, H. J., Ruwaard, D., Hegbrant, J., & Strippoli, G. F. (2019) · PLoS ONE · doi:10.1371/journal.pone.0222593 · Cited by 46
Goodwin, N., & Lawton-Smith, S. H. (2010) · International Journal of Integrated Care · doi:10.5334/ijic.516 · Cited by 45
“Reviews of the integrated care literature internationally (for example on case management and disease management of people with LTCs) show how our conceptual understanding of the issues varies widely and that understanding what works is a complex and context-specific task [19].”
BackgroundIntegrated care in Switzerland: Results from the first nationwide survey
Filliettaz, S. S., Berchtold, P., Kohler, D., & Peytremann‐Bridevaux, I. (2018) · Health Policy · doi:10.1016/j.healthpol.2018.03.006 · Cited by 44
“It is also difficult to generalize results and to prioritize implementation efforts [10,24].”
BackgroundThe Generation of Integration: The Early Experience of Implementing Bundled Care in Ontario, Canada
Embuldeniya, G., Kirst, M. J., Walker, K., & Wodchis, W. P. (2018) · Milbank Quarterly · doi:10.1111/1468-0009.12357 · Cited by 44
The current state of integrated care: an overview
Minkman, M. M. N. (2012) · Journal of Integrated Care · doi:10.1108/14769011211285147 · Cited by 44
“The aims are to reduce the fragmentation and costs of care and to improve clinical outcomes, quality of life, patient satisfaction, effectiveness (using evidence-based guidelines) and efficiency (Kodner, 2009; Kodner and Spreeuwenberg, 2002; Shortell, 2009; Stein, 2010).”
BackgroundInfluentialA 10 Step Framework to Implement Integrated Care for Older Persons
Harnett, P. J., Kennelly, S., & Williams, P. A. (2019) · Ageing International · doi:10.1007/s12126-019-09349-7 · Cited by 43
“There were multiple definitions of integrated care available (Kodener and Spreeuwenberg 2002) and the core design elements are well defined (Kodner 2009; Minkman 2015; Leutz 1999; Tsasis et al. 2012; Booker et al. 2015; Valentijn 2015).”
BackgroundAnsa, G. A., Walley, J. D., Siddiqi, K., & Wei, X. (2012) · Infectious Diseases of Poverty · doi:10.1186/2049-9957-1-13 · Cited by 42
“In TB and HIV control, integration of services has emerged as an essential component in any country’s response to the TB/HIV dual epidemic – the aim being to create coherence and synergy between the two programmes, not only to address problems with access and fragmentation, but also to enhance efficiency, quality of c…”
BackgroundIntegrated oncogeriatric approach: a systematic review of the literature using concept analysis
Tremblay, D., Charlebois, K., Terret, C., Joannette, S., & Latreille, J. (2012) · BMJ Open · doi:10.1136/bmjopen-2012-001483 · Cited by 43
“tals, primary healthcare facilities, human and social services and communities.(76) Formalising such networks facilitates the seamless delivery of services(76) and the comprehensive assessment of the patient’s multiple evolving needs.”
BackgroundValentijn, P., Biermann, C. W., & Bruijnzeels, M. A. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1586-0 · Cited by 41
“These findings are not surprising, given the prime focus of practice, science and policies on the clinical and professional domain of integrated care [6, 14, 15, 39].”
BackgroundDespite all we Know about Collaborative Working, Why do we Still Get it Wrong?
Williams, P., & Sullivan, H. T. (2010) · Journal of Integrated Care · doi:10.5042/jic.2010.0373 · Cited by 39
Building a taxonomy of integrated palliative care initiatives: results from a focus group
Ewert, B., Hodiamont, F., van Wijngaarden, J. D. H., Payne, S. A., Groot, M. M., Hasselaar, J. G. J., Menten, J. J., & Radbruch, L. (2015) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2014-000841 · Cited by 39
Jackson, K., Oelke, N. D., Besner, J., & Harrison, A. (2012) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980812000086 · Cited by 38
Banfield, M., Jowsey, T., Parkinson, A., Douglas, K. A., & Dawda, P. (2017) · BMC Family Practice · doi:10.1186/s12875-016-0575-z · Cited by 38
Court, L., & Olivier, J. (2020) · Health Policy and Planning · doi:10.1093/heapol/czaa026 · Cited by 38
Interventions to Prevent Potentially Avoidable Hospitalizations: A Mixed Methods Systematic Review
Lyhne, C. N., Bjerrum, M. B., Riis, A. H., & Jørgensen, M. J. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.898359 · Cited by 44
“Based on our results, and in line with other studies (7, 83, 84), it can be concluded that a fragmented healthcare system tends to result in suboptimal care and poor quality of care, which may impose a risk for patient safety and avoidable hospitalizations.”
Resultvan Rensburg, A. J., & Fourie, P. (2016) · International Journal of Mental Health Systems · doi:10.1186/s13033-016-0081-7 · Cited by 41
“Within this broad categorisation, integrated care has been used to refer to as a patient-centred, demand-driven linking of the health care system with other human service systems on multiple levels to address complex health needs [25, 36, 37]; the consolidation of a range of behavioural, medical and other elements int…”
BackgroundProject INTEGRATE - a common methodological approach to understand integrated health care in Europe
Cash‐Gibson, L., & Rosenmöller, M. (2014) · International Journal of Integrated Care · doi:10.5334/ijic.1980 · Cited by 37
“These items, considered by the literature as crucial for integrated care [3–5], form part of the main components of integrated health systems [6]: process management, human resources management, financial flows, patients’ involvement and information communication technology management.”
BackgroundPatient perceptions of integrated care: confused by the term, clear on the concept
Walker, K. O., Labat, A., Choi, J. M., Schmittdiel, J. A., Stewart, A. L., & Grumbach, K. (2013) · International Journal of Integrated Care · doi:10.5334/ijic.985 · Cited by 36
“The lack of standard metrics reflects what has been described as the ‘elastic’ and ‘bewildering’ terminology and conceptual models of integrated care [9].”
BackgroundTransforming our health care system
Naylor, C., Imison, C., Addicott, R., Buck, D., Goodwin, N., Harrison, T., Ross, S., Sonola, L., Tian, Y., & Curry, N. (2013) · Cited by 37
Kassianos, A. P., Ignatowicz, A., Greenfield, G., Majeed, A., Car, J., & Pappas, Y. (2015) · International Journal of Integrated Care · doi:10.5334/ijic.2019 · Cited by 36
Valentijn, P., Ruwaard, D., Vrijhoef, H. J., Bont, A. A. D., Arends, R., & Bruijnzeels, M. A. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-1125-4 · Cited by 35
“secondary and tertiary care) and countries, due to differing cultural and organisational contexts [2, 55].”
BackgroundDevelopment of a survey instrument to measure patient experience of integrated care
Walker, K. O., Stewart, A. L., & Grumbach, K. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1437-z · Cited by 35
“An important health system goal is achieving “integrated care”— a sense of “cohesiveness and connectedness of the health care system” [1].”
BackgroundAn Instrument to Measure Maturity of Integrated Care: A First Validation Study
Grooten, L., Borgermans, L. A. D., & Vrijhoef, H. J. (2018) · International Journal of Integrated Care · doi:10.5334/ijic.3063 · Cited by 39
“” As a response to the call for the establishment of a common language and framework of integrated care to better understand integrated care and guide empirical research [10, 11], several studies have attempted to clarify the concepts underpinning integrated care [8, 12].”
BackgroundCodesigning a Measure of Person-Centred Coordinated Care to Capture the Experience of the Patient
Sugavanam, T., Fosh, B., Close, J., Byng, R., Horrell, J., & Lloyd, H. M. (2018) · Journal of Patient Experience · doi:10.1177/2374373517748642 · Cited by 36
“People with LTCs and MLTCs often describe their care as fragmented and lacking in continuity (6-8) and call for better coordination of their care (9).”
BackgroundCitizens as Active Participants in Integrated Care: Challenging the Field’s Dominant Paradigms
Glimmerveen, L. M., Nies, H. L. G. R., & Ybema, S. B. (2019) · International Journal of Integrated Care · doi:10.5334/ijic.4202 · Cited by 35
Meza-Torres, B., Carinci, F., Heiß, C., Joy, M., & de Lusignan, S. (2021) · Acta Diabetologica · doi:10.1007/s00592-020-01662-x · Cited by 38
Nicholson, C., Hepworth, J., Burridge, L. H., Marley, J. E., & Jackson, C. L. (2018) · International Journal of Integrated Care · doi:10.5334/ijic.3106 · Cited by 35
“Integrated care is a patient-centred, multi-level, multi-method strategy designed to achieve improved coordination of services across the care continuum of complex health systems [3, 10, 11].”
BackgroundLai, Y. F., Lum, A. Y. W., Ho, E. T. L., & Lim, Y. W. (2017) · PLoS ONE · doi:10.1371/journal.pone.0187372 · Cited by 34
Integrated Care for Frail Elderly: A Qualitative Study of a Promising Approach in The Netherlands
Hoedemakers, M. J., Leijten, F., Looman, W., Czypionka, T., Kraus, M., Donkers, H., den Hende-Wijnands, E. V., van den Broek, N. M. A., & Mölken, M. R. (2019) · International Journal of Integrated Care · doi:10.5334/ijic.4626 · Cited by 34
Xu, J., Pan, R., Pong, R., Miao, Y., & Qian, D. (2016) · International Journal of Integrated Care · doi:10.5334/ijic.2456 · Cited by 34
“Nowadays, health service integration, especially concerning chronic diseases, is one of the major tasks of health system reform in many countries [3] and is also seen as a way to improve quality of care and lower healthcare costs [4, 5].”
BackgroundCortis, L. J., Ward, P., McKinnon, R. A., & Koczwara, B. (2017) · European Journal of Cancer Care · doi:10.1111/ecc.12689 · Cited by 34
“…the health system (health system, organisation, clinical setting), focus (target population), direction (horizontal – affecting organisations at same level and, vertical – affecting organisations at different levels i.e. primary and secondary care) and type of intervention involved (Kodner, 2009).”
BackgroundInfluentialBainbridge, D. B., Brazil, K., Ploeg, J., Krueger, P. D., & Taniguchi, A. (2016) · Palliative Medicine · doi:10.1177/0269216315619862 · Cited by 33
“As the first key steps in considering the “case,” the initial lines of enquiry were as follows: (1) development of a complete understanding of the network being examined, and (2) application of this understanding within the broader range of theory and practice as reflected by previous research (i.”
Joober, H., Chouinard, M., King, J., Lambert, M., Hudon, É., & Hudon, C. (2018) · International Journal of Integrated Care · doi:10.5334/ijic.4163 · Cited by 33
What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care
Nooteboom, L. A., Kuiper, C. H. Z., Mulder, E. A., Roetman, P. J., Eilander, J., & Vermeiren, R. R. J. M. (2020) · International Journal of Integrated Care · doi:10.5334/ijic.5419 · Cited by 38
Examining the extent and factors associated with interprofessional teamwork in primary care settings
Khan, A. I., Barnsley, J., Harris, J. K., & Wodchis, W. (2021) · Journal of Interprofessional Care · doi:10.1080/13561820.2021.1874896 · Cited by 35
“It is driven by shared responsibility and accountability between providers to deliver a continuous, comprehensive, and coordinated continuum of care (Kodner, 2009; Valentijn et al., 2013).”
BackgroundConceptual framework: factors enabling collaborative healthcare and social services integration
Cheng, S. M., & Catallo, C. (2020) · Journal of Integrated Care · doi:10.1108/jica-11-2019-0048 · Cited by 32
Doucet, S., Splane, J., Luke, A., Asher, K., Breneol, S., Pidduck, J., Grant, A., Dionne, E., Scott, C., Keeping-Burke, L., et al. (2022) · Child: Care, Health and Development · doi:10.1111/cch.12984 · Cited by 31
“, 2011); (4) fragmentation of care (Gauvin et al., 2014; Kodner, 2009; National Research Council, 2015; Rich et al., 2012); and (5) deterioration of health due to lack of follow-up visits or the emergence of mental health conditions (Lee et al.”
BackgroundBhat, K., Easwarathasan, R., Jacob, M., Poole, W., Sapaetharan, V., Sidhu, M., & Thomas, A. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-049296 · Cited by 32
Metadata
- Authors
- Kodner, D.
- Affiliations
- American Medical Association (US)
- Corresponding author
- Kodner, Dennis
- Venue
- Healthcare Quarterly
- Publisher
- Longwoods Publishing
- Published
- 2009-10-16
- Volume
- 13
- Issue
- sp
- Pages
- 6-15
- ISSN
- 1710-2774 (ISSN-L)
- 1929-6347
- OpenAlex
- W2138401727
- Cited by
- 434
- References
- 40
- Citations by year
- 2026: 8 · 2025: 26 · 2024: 23 · 2023: 24 · 2022: 31 · 2021: 42 · 2020: 30 · 2019: 22 · 2018: 36 · 2017: 33 · 2016: 38 · 2015: 29 · 2014: 25 · 2013: 29 · 2012: 19
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Healthcare Quarterly (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Services Management and Policy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Practices
- Keywords
- integrated care, health care reform, service integration, conceptual definitions, health system integration, care coordination
- MeSH terms
- Canada, Continuity of Patient Care, Decision Support Techniques, Humans, Managed Care Programs, Models, Theoretical, Operations Research, Philosophy, Medical, United States, Models, Organizational, Practice Guidelines as Topic, Health Care Reform, Systems Integration, Delivery of Health Care, Integrated, Case Management, Critical Pathways, Disease Management
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