Priorities in integrated care: A scoping review.

Corey Burke, John Broughan, Geoff Mccombe, Áine Carroll, Ronan Fawsitt, Walter Cullen

Keywords: care coordination, Integrated healthcare systems, integration model, priorities, review

Fragmentation is a feature of many healthcare systems and can lead to adverse effects on the quality of care and health outcomes. Further, as evidenced during the COVID-19 pandemic, these issues are amplified when populations and their healthcare demands increase. It is commonly believed that an integrated care approach may solve many of the problems associated with fragmented healthcare systems. However, despite integrated care’s growing popularity, its priorities are unclear.

Research questions:
What are the priority areas when developing and implementing integrated care models?

A scoping review was conducted using Arksey and O’Malley’s 2005 six-stage framework. Twenty-one papers were selected for review. The studies spanned numerous geographical locations, encompassing several study designs, and a range of populations and sample sizes. Integrated care priorities were identified qualitatively using a thematic analysis approach.

Overall, the findings show that while no one integrated care model fits all health systems, four priority areas should be considered when designing and implementing policy and care models. These areas are (i) communication, (ii) coordination, collaboration, and cooperation, (iii) responsibility and accountability, and (iv) a population approach. Multiple elements were also identified within these themes, all of which are required to ensure successful and sustained integration. These elements included education, efficiency, patient-centredness, safety, trust, and time.

The identified priority areas should guide policymakers when planning and implementing future integrated care models. Meanwhile, future research should evaluate the implementation of these priorities in integrated healthcare settings.

Points for discussion:
Challenges facing integrated healthcare systems.

Solutions to overcome these challenges.

Future directions for research, policy, and clinical practice