A governance model for integrated primary/ secondary care for the health-reforming first world: results of a systematic review

Nicholson, Caroline, Jackson, Claire and Marley, John (2013) A governance model for integrated primary/ secondary care for the health-reforming first world: results of a systematic review. BMC Health Services Research, 13 528: 1-12. doi:10.1186/1472-6963-13-528

Attached Files (Some files may be inaccessible until you login with your UQ eSpace credentials)
Name Description MIMEType Size Downloads
UQ322152.pdf Full text (open access) application/pdf 683.28KB 63

Author Nicholson, Caroline
Jackson, Claire
Marley, John
Title A governance model for integrated primary/ secondary care for the health-reforming first world: results of a systematic review
Journal name BMC Health Services Research   Check publisher's open access policy
ISSN 1472-6963
Publication date 2013-12-20
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1186/1472-6963-13-528
Open Access Status DOI
Volume 13
Issue 528
Start page 1
End page 12
Total pages 12
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2014
Language eng
Formatted abstract
Background Internationally, key health care reform elements rely on improved integration of care between the primary and secondary sectors. The objective of this systematic review is to synthesise the existing published literature on elements of current integrated primary/secondary health care. These elements and how they have supported integrated healthcare governance are presented.

Methods A systematic review of peer-reviewed literature from PubMed, MEDLINE, CINAHL, the Cochrane Library, Informit Health Collection, the Primary Health Care Research and Information Service, the Canadian Health Services Research Foundation, European Foundation for Primary Care, European Forum for Primary Care, and Europa Sinapse was undertaken for the years 2006–2012. Relevant websites were also searched for grey literature. Papers were assessed by two assessors according to agreed inclusion criteria which were published in English, between 2006–2012, studies describing an integrated primary/secondary care model, and had reported outcomes in care quality, efficiency and/or satisfaction.

Results Twenty-one studies met the inclusion criteria. All studies evaluated the process of integrated governance and service delivery structures, rather than the effectiveness of services. They included case reports and qualitative data analyses addressing policy change, business issues and issues of clinical integration. A thematic synthesis approach organising data according to themes identified ten elements needed for integrated primary/secondary health care governance across a regional setting including: joint planning; integrated information communication technology; change management; shared clinical priorities; incentives; population focus; measurement — using data as a quality improvement tool; continuing professional development supporting joint working; patient/community engagement; and, innovation.

Conclusions All examples of successful primary/secondary care integration reported in the literature have focused on a combination of some, if not all, of the ten elements described in this paper, and there appears to be agreement that multiple elements are required to ensure successful and sustained integration efforts. Whilst no one model fits all systems these elements provide a focus for setting up integration initiatives which need to be flexible for adapting to local conditions and settings.
Keyword Primary/secondary integration
Governance
Health system
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: Scopus Citation Count Cited 12 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 04 Feb 2014, 09:05:59 EST by Shani Lamb on behalf of Discipline of General Practice