Values of Integrated Care: A Systematic Review (2) What is integrated care?

5 December, 2018

Dear HIFA colleagues,

This systematic review raised for me the question: what exactly do we mean by 'integrated care'?

The term is defined and therefore understood differently by different people. Indeed, the King's Fund claims there are at least 175 different definitions:

http://www.pulsetoday.co.uk/home/practical-commissioning/there-are-175-d...

The authors of the systematic review point to a WHO definition: 'WHO defines integrated care (or integrated health services delivery) as “an approach to strengthen people-centred health systems through the promotion of the comprehensive delivery of quality services across the life-course, designed according to the multidimensional needs of the population and the individual and delivered by a coordinated multidisciplinary team of providers working across settings and levels of care. It should be effectively managed to ensure optimal outcomes and the appropriate use of resources based on the best available evidence, with feedback loops to continuously improve performance and to tackle upstream causes of ill health and to promote well-being through intersectoral and multisectoral actions”'

But is 'integrated care' equivalent to 'integrated health services'?

WHO itself uses the compound term 'integrated people-centred health services'

https://www.who.int/servicedeliverysafety/areas/people-centred-care/fram...

and introduces the concept as:

'Integrated people-centred health services means putting people and communities, not diseases, at the centre of health systems, and empowering people to take charge of their own health rather than being passive recipients of services.'

https://www.who.int/servicedeliverysafety/areas/people-centred-care/ipch...

The emphasis on people empowerment is notable and aligns with the work of (a) the HIFA working group on meeting the information needs of citizens, families and children, and (b) the Mobile Healthcare Information For All working group, which is campaigning (with unexpected resistance/inertia) to promote the concept of putting life-saving information (such as Where There is No Doctor or Red Cross First Aid app) into the hands of every person.

The International Journal of Integrated Care defines integrated care as follows:

'Integration is a coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment and collaboration within and between the cure and care sectors. The goal of these methods and models is to enhance quality of care and quality of life, consumer satisfaction and system efficiency for patients ... cutting across multiple services, providers and settings. [Where] the result of such multi-pronged efforts to promote integration [lead to] the benefit of patient groups [the outcome can be] called 'integrated care' (Kodner and Spreeuwenberg, 2002).'

The term has also been used to describe the (quite different) concepts of integration of complementary and allopathic medicine.

Best wishes, Neil

Coordinator, HIFA Project on Information for Citizens, Parents and Children:

http://www.hifa.org/projects/citizens-parents-and-children

Coordinator, mHIFA Project (Mobile Healthcare Information For All)

http://www.hifa.org/projects/mobile-hifa-mhifa

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 18,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG /orcid.org/0000-0001-9557-1487 neil@hifa.org