Combining Integration of Care and a Population Health Approach: A Scoping Review of Redesign Strategies and Interventions, and their Impact
Open Access
- 11 April 2019
- journal article
- review article
- Published by Ubiquity Press, Ltd. in International Journal of Integrated Care
- Vol. 19 (2), 5
- https://doi.org/10.5334/ijic.4197
Abstract
Background and aim: Many health systems attempt to develop integrated and population health-oriented systems of care, but knowledge of strategies and interventions to support this effort is lacking. We aimed to identify specific redesign strategies and interventions, and to present evidence of their effectiveness. Method: A modified scoping review process was carried out. Fifteen relevant examples of integrated care organizations that incorporated a broad population health approach in countries of the Organization for Economic Cooperation and Development described in 57 articles and reports were included in analysis. Results: Seven key redesign strategies and multiple redesign interventions have been identified and are described. Most commonly used redesign strategies included focusing on health and wellness, embracing intersectoral action and partnerships, addressing health in vulnerable groups, and addressing a wide range of determinants of health, including making improvements in health services. Redesign interventions included creative and innovative ways of addressing clinical and non-clinical issues such as establishing housing surgeries in primary care, establlishing vast social and provider networks to support patients with complex needs and also broadening of the scope of services, workforce redesign and other. Potential reductions in the utilization of care and costs could be derived by the wider adoption of these strategies and interventions. Conclusion: Development of integrated and population health-oriented systems of care requires the redesign of how services are organized and delivered, and how organizations and care systems operate. Combining integration of care with the population health approach can be supported by a set of cohesive strategies and interventions aimed at preventing disease, addressing social determinants of health and improving health equity at both population- and individual-level.Keywords
This publication has 48 references indexed in Scilit:
- Embrace, a model for integrated elderly care: study protocol of a randomized controlled trial on the effectiveness regarding patient outcomes, service use, costs, and quality of careBMC Geriatrics, 2013
- The Nuka System of Care: improving health through ownership and relationshipsInternational Journal of Circumpolar Health, 2013
- Reduced acute hospitalisation with the healthy housing programmeJournal of Epidemiology and Community Health, 2011
- The Triple Aim: Care, Health, And CostHealth Affairs, 2008
- Bringing health home: Householder and provider perspectives on the healthy housing programme in Auckland, New ZealandSocial Science & Medicine (1982), 2008
- Understanding Population Health TerminologyThe Milbank Quarterly, 2007
- Making Systemwide Improvements in Health CareQuality Management in Health Care, 2007
- MEASURING POPULATION HEALTH: A Review of IndicatorsAnnual Review of Public Health, 2006
- International experiments in integrated care for the elderly: a synthesis of the evidenceInternational Journal of Geriatric Psychiatry, 2003
- Five Laws for Integrating Medical and Social Services: Lessons from the United States and the United KingdomThe Milbank Quarterly, 1999