This paper reviews, rethinks, expands and applies the author's ‘laws’ of integration, which were first published six years ago. This approach both introduces the laws to readers…
Abstract
This paper reviews, rethinks, expands and applies the author's ‘laws’ of integration, which were first published six years ago. This approach both introduces the laws to readers who don't know them, and tests their utility for those who do. In retrospect, real‐world integration efforts mix and match the original components of linkage, co‐ordination and full integration. But the message remains to work at all levels, keep it simple, make finances supportive and empower social care.
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Jill Manthorpe and Steve Iliffe
The purpose of this paper is to discuss the different meanings of integration as expressed in dementia care practice and service organisation in England. Dementia is frequently…
Abstract
Purpose
The purpose of this paper is to discuss the different meanings of integration as expressed in dementia care practice and service organisation in England. Dementia is frequently complicated by concurrent illnesses or long-term conditions at the end of life.
Design/methodology/approach
This is a policy discussion.
Findings
The paper describes three forms of integration: linkage, co-ordination of care, and full integration. Each form or level is related to dementia as a progressive neurological disorder with multiple symptoms, which also overlaps with other long-term conditions, making each individual’s dementia unique. Linkage means being able to identify appropriate resources to meet the needs of the individual and their family. Co-ordination usually means multi-disciplinary working at least with general practice and often wider practitioner input. Full integration is best expressed by the work of care homes, which co-ordinate care and often draws on diverse funding streams.
Practical implications
Greater specificity of the meaning of integration may be helpful to policy makers and practitioners. The care and treatment of people with dementia may be optimised if practitioners think about work styles and engagement with other sectors, agencies and professionals rather than pursuing all-encompassing organisational integration. Care homes may have much to teach other practice settings about full integration.
Originality/value
Integration is often seen uncritically as the solution to all problems; this paper explores the varieties of integration and explores their implications for practitioners and policy makers supporting people with dementia and their carers.
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Helen Dickinson, Jon Glasby, Robin Miller and Linda McCarthy
Health and social care partnership working is often predicated on the notion that it improves outcomes for service users. Yet there is a lack of evidence linking partnerships to…
Abstract
Health and social care partnership working is often predicated on the notion that it improves outcomes for service users. Yet there is a lack of evidence linking partnerships to changes in outcomes. Against this background, the Health Services Management Centre at the University of Birmingham designed the Partnership Outcomes Evaluation Toolkit (POET) specifically to evaluate health and social care partnerships in terms of service user outcomes. This paper reports on the field testing of POET with Sandwell Integrated Support Service. This research provided a number of interesting insights into this service, and indicated some dissonance between staff and service user and carer expectations.
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Johanna Andersson, Mikael Löfström, Susanna Bihari Axelsson and Runo Axelsson
A Swedish framework law has enabled integration between public agencies in vocational rehabilitation. With the support of this law, coordination associations can be formed to fund…
Abstract
Purpose
A Swedish framework law has enabled integration between public agencies in vocational rehabilitation. With the support of this law, coordination associations can be formed to fund and organize joint activities. The purpose of this study is to describe and analyze how the law has been interpreted and translated into local coordination associations and how local institutional logics have developed to guide the organization of these associations.
Design/methodology/approach
Data was collected through observations of meetings within two coordination associations and supplemented with documents. The material was analyzed by compilation and examination of data from field notes, whereupon the most important aspects were crystallized and framed with institutional organization theory.
Findings
Two different translations of the law were seen in the associations studied: the association as an independent actor, and as an arena for its member organizations. Two subsequent institutional logics have developed, influencing decisions on autonomy, objectives and rationality for initiating and organizing in the two associations and their activities. The institutional logics are circular, further enhancing the different translations creating different forms of integration.
Research implications/limitations
Both forms of integration are legitimate, but the different translations have created integration with different degrees of autonomy in relation to the member organizations. Only a long‐term analysis can show whether one form of integration is more functional than the other.
Originality/value
This article is based on an extensive material providing insights into a form of interorganizational integration which has been scarcely researched. The findings show how different translations can influence the integration of welfare services.
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Tsung‐hsi Fu and Rhidian Hughes
The purpose of this paper is to analyse the extent to which Taiwan's current policy agenda is moving towards an improved system of integrated health and social services. The paper…
Abstract
Purpose
The purpose of this paper is to analyse the extent to which Taiwan's current policy agenda is moving towards an improved system of integrated health and social services. The paper informs debates about integrated care internationally.
Design/methodology/approach
The case study draws on existing literature and policy documents to analyse the progress of integrated care in Taiwan, with wider implications identified internationally.
Findings
For many years Taiwan's health care and social services were separated, however, there is growing momentum for integrated care in politics, policy and practice. There are, however, a number of critical issues that need to be addressed if Taiwan is to realise its ambitions for a truly integrated system.
Research limitations/implications
This is a small case study and overview, with the limited aim of exploring Taiwan's progress in an international context.
Originality/value
The paper contributes to an emerging body of literature on integrated care in Taiwan (some only available in Chinese), which will be of interest to policy makers and planners, not only in East Asia but internationally.