Abstract
Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems. A systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources. Despite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging. Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration.
Highlights
Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide
Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care
Systematic literature reviews have a role to play in providing planners and decision makers with a synthesis of current evidence-based knowledge [9, 11,12,13,14,15] to assist with the planning and implementation of health systems integration
Summary
Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. The benefits of systematic literature reviews for decision makers and planners include: (a) less reliance on a single research study and the opportunity to view possibly divergent studies together, facilitating a comparison of the findings and providing a synthesis of the challenges and advantages of models, processes, or strategies from a variety of perspectives [14, 21, 22], and (b) time-savings since the underpinning of systematic literature reviews is the rigorous evaluation and synthesis of the findings reported in the literature making for easier access to evidence-based information [14, 21]
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