The Evolution Of Integrated Health Care Strategies
Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
ISBN: 978-1-78350-715-3
Publication date: 11 August 2014
Abstract
Purpose
To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international academic research and literature.
Methods
A search of the health sciences literature was conducted using PubMed and EMBASE. A total of 114 articles were identified for inclusion and thematically analyzed using a strategy content model for systems-level integration.
Findings
Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution-centered models of integration to a broader focus on community-based health and social services; (3) from economic arguments for integration to an emphasis on improving quality of care and creating value; (4) from evaluations of integration using an organizational perspective to an emerging interest in patient-centered measures; (5) from a focus on modifying organizational and environmental structures to an emphasis on changing ways of working and influencing underlying cultural attitudes and norms; and (6) from integration for all patients within defined regions to a strategic focus on integrating care for specific populations. We propose that underlying many of these shifts is a growing recognition of the value of understanding health care delivery and integration as processes situated in Complex-Adaptive Systems (CAS).
Originality/value
This review builds a descriptive framework against which to assess, compare, and track integration strategies over time.
Keywords
Acknowledgements
Acknowledgments
An earlier and shorter version of this chapter was published in the Academy of Management’s 2013 Best Paper Proceedings. Jenna M. Evans is funded by a Vanier Canada Graduate Scholarship and by the Health System Performance Research Network (HSPRN).
Citation
Evans, J.M., Baker, R.G., Berta, W. and Jan, B. (2014), "The Evolution Of Integrated Health Care Strategies", Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization (Advances in Health Care Management, Vol. 15), Emerald Group Publishing Limited, Leeds, pp. 125-161. https://doi.org/10.1108/S1474-8231(2013)0000015011
Publisher
:Emerald Group Publishing Limited
Copyright © 2013 by Emerald Group Publishing Limited