The complexity of health service integration: a review of reviews

Heyeres, Marion, McCalman, Janya, Tsey, Komla, and Kinchin, Irina (2016) The complexity of health service integration: a review of reviews. Frontiers in Public Health, 4. 223. pp. 1-8.

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Background: The aim of health service integration is to provide a sustainable and integrated health system that better meets the needs of the end user. Yet, definitions of health service integration, methods for integrating health services, and expected outcomes are varied. This review was commissioned by Queensland Health, the government department responsible for health service delivery in Queensland, Australia, to inform efforts to integrate their mental health services. This review reports on the characteristics, reported outcomes, and design quality of studies included in systematic reviews of health service integration research.

Method: The review was developed by systematically searching nine electronic data-bases to find peer-reviewed Australian and international systematic reviews with a focus on health service integration. Reviews were included if they were in the English language and published between 2000 and 2015. A standardized assessment tool was used to analyze the study design quality of included reviews. Data relating to the integration types, methods, and reported outcomes of integration were synthesized.

Results: Seventeen publications met the inclusion criteria. Eleven (65%) reviews were published during the past 5 years, which may indicate a trend for increased awareness of the need for service integration. The majority of reviews were published by researchers in the UK (8/47%), USA (3/18%), and Australia (3/18%). Included reviews focused on a variety of integration types, including integrated care pathways, governance models, integration of interventions, collaborative/integrated care models, and integration of different types of health care. Most (53%) of the reviews reported on the cost-effectiveness of service integration, e.g., positive results, no effect, or inconclusive. Only one of the reviews reported on the importance of consumer involvement. The overall design of 70% of the reviews was high, 18% medium, and 12% low.

Conclusion: There is no "one size fits all" approach to health service integration. Instead, this literature review highlighted the complexity of service integration, which in most primary studies involved a range of strategies. Rigorous assessments of cost-effectiveness and reporting on consumer involvement are required in future research.

Item ID: 46158
Item Type: Article (Research - C1)
ISSN: 2296-2565
Keywords: integration, health service, health-care system, collaboration, governance
Additional Information:

© 2016 Heyeres, McCalman, Tsey and Kinchin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Funders: Queensland Health (QH), National Health and Medical Research Council (NHMRC)
Projects and Grants: QH Project: Developing an evaluation framework for the Cairns PARC Service, Mind Australia, NHMRC Early Career Fellowship APP1113392
Date Deposited: 23 Nov 2016 02:32
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420313 Mental health services @ 30%
42 HEALTH SCIENCES > 4203 Health services and systems > 420311 Health systems @ 30%
42 HEALTH SCIENCES > 4204 Midwifery > 420402 Models of care and place of birth @ 40%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920410 Mental Health @ 50%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 50%
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