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. 2013 Mar 22:13:e010.
doi: 10.5334/ijic.886. Print 2013 Jan-Mar.

Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care

Pim P Valentijn  1 , Sanneke M Schepman, Wilfrid Opheij, Marc A Bruijnzeels
Affiliations

Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care

Pim P Valentijn et al. Int J Integr Care. .

Abstract

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.

Keywords: care coordination; collaboration; fragmentation; integrated care; primary care.

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Figures

Figure 1.
Figure 1.
System integration.
Figure 2.
Figure 2.
Continuum of inter-organisational integration. Source: Adapted from Gomes-Casseres (2003) [44] and Ahgren and Axelsson (2005) [41].
Figure 3.
Figure 3.
Conceptual framework for integrated care based on the integrative functions of primary care.
See this image and copyright information in PMC

References

    1. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Global burden of disease and risk factors. New York: The World Bank and Oxford University Press; 2006. - PubMed
    1. World Health Organization (WHO) Scaling up action against noncommunicable diseases: how much will it cost. Geneva: World Health Organization; 2011.
    1. Gröne O, Garcia-Barbero M. Integrated care: a position paper of the WHO European office for integrated health care services. International Journal of Integrated Care [serial online] 2001 Jun 1;1 Available from: http://www.ijic.org. - PMC - PubMed
    1. Armitage GD, Suter E, Oelke ND, Adair CE. Health systems integration: state of the evidence. International Journal of Integrated Care [serial online] 2009 Jun 17;9 [cited 2013 Mar 6]. Available from: http://www.ijic.org. URN:NBN:NL:UI:10-1-100558. - PMC - PubMed
    1. Kodner DL. All together now: a conceptual exploration of integrated care. Healthcare Quarterly. 2009 Oct;13 Spec No: 6-15. - PubMed

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