Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care
Open accessAbstract
INTRODUCTION: Primary care has a central role in integrating care within a health system. However, conceptual ambiguity regarding integrated care hampers a systematic understanding. This paper proposes a conceptual framework that combines the concepts of primary care and integrated care, in order to understand the complexity of integrated care. METHODS: The search method involved a combination of electronic database searches, hand searches of reference lists (snowball method) and contacting researchers in the field. The process of synthesizing the literature was iterative, to relate the concepts of primary care and integrated care. First, we identified the general principles of primary care and integrated care. Second, we connected the dimensions of integrated care and the principles of primary care. Finally, to improve content validity we held several meetings with researchers in the field to develop and refine our conceptual framework. RESULTS: The conceptual framework combines the functions of primary care with the dimensions of integrated care. Person-focused and population-based care serve as guiding principles for achieving integration across the care continuum. Integration plays complementary roles on the micro (clinical integration), meso (professional and organisational integration) and macro (system integration) level. Functional and normative integration ensure connectivity between the levels. DISCUSSION: The presented conceptual framework is a first step to achieve a better understanding of the inter-relationships among the dimensions of integrated care from a primary care perspective.
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Better integration and coordination of health and other care services have been called for.
“To this end, better integration and coordination of health and other care services have been called for [41]”
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- Authors
- Valentijn, P. P., Schepman, S. M., Opheij, W., & Bruijnzeels, M. A.
- Affiliations
- Netherlands Institute for Health Services Research (NL)
- Venue
- International Journal of Integrated Care
- Publisher
- Ubiquity Press, Ltd.
- Published
- 2013-03-22
- Volume
- 13
- Issue
- 1
- Pages
- e010-e010
- ISSN
- 1568-4156 (ISSN-L)
- PMC
- PMC3653278
- OpenAlex
- W2119091118
- Cited by
- 1,174
- References
- 58
- Citations by year
- 2026: 130 · 2025: 118 · 2024: 131 · 2023: 129 · 2022: 122 · 2021: 133 · 2020: 85 · 2019: 78 · 2018: 87 · 2017: 59 · 2016: 47 · 2015: 33 · 2014: 17 · 2013: 3
- FWCI
- 60.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Integrated Care (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- International Journal of Integrated Care (IJIC) (acceptedVersion, cc-by)
- Research portal (Tilburg University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Keywords
- integrated care, primary care, conceptual framework, person-focused care, population-based care, continuum of care, clinical integration, organizational integration, system integration, health system integration
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