Abstract
Experiencing integration in Australian primary health care: a pilot study
Highlights
Integrated care means different things to different people
Contributing further to its complexity, integration occurs between different levels of the health system: vertical integration, such as between acute and primary care organisations; and horizontal integration such as between general practitioners (GPs) and allied health professionals
Health professionals had a strong focus on clinical level integration, and talked about integration at the service and organisational levels, as well as functional and normative integration
Summary
Integrated care means different things to different people. We often find the terms ‘integration’ and ‘integrated care’ used interchangeably. Kodner and Spreeuwenberg (2002) suggest ‘integration’ refers to structures and proc esses, while ‘integrated care’ refers more to patient experiences and the outcomes of such processes. A starting point for understanding how integration operates as a process is the seminal work by Fulop et al (2005), which recognises the importance of process and cultural changes in addition to structures and governance. They identify six dimensions needed for effective integration. Factors such as the structure of the organisation (organisational integration); non-clinical and back office processes (functional integration); organisation level clinical services (service integration); clinical team level care pathways (clinical integration); as well as the role of shared values (normative integration); and, the coherence of policies across organisational levels (systemic integration)
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