Potential barriers to public awareness of integrated healthcare

Abstract

The aim of this abstract is to focus on aspects of the regulatory framework that could potentially hinder the implementation of integrated healthcare when seen in the context of vertical integration. Integrated healthcare has been advocated in concept for a long time. International organisations, including the World Health Organisation, are promoting initiatives such as Integrated Delivery Networks, and the European Framework for Action on Integrated Health Services Delivery, which aim to support integrative approaches and reduce fragmentation of care. Within the European Union, the integrative approach is also supported by a number of initiatives and projects. At the same time, it should be borne in mind that healthcare is a multidisciplinary system in which the pharmaceutical industry also plays an important role. Moreover, the pharmaceutical sector is a highly competitive and regulated field, which is also subject to several constraints. Among them, the European Commission in its report "Competition enforcement in the pharmaceutical sector (2009-2017)" (Brussels, 28.1.2019) had reported on breaches of competition law found by national authorities related, inter alia, to vertical agreements. Vertical integration in the pharmaceutical business is seen in many countries as a competition-threatening factor when medical institutions and laboratories become owned by the pharmaceutical industry. Consequently, it can be assumed that there is a partial conceptual reluctance in society toward the introduction of "integrated healthcare". This aspect should be taken into account when working on the motivating and inhibiting factors for the introduction of integrated healthcare. This is an example of how influencing factors can be related not only to administrative issues and the involvement of doctors and patients in the implementation of integrated healthcare, but also to the public acceptance of a particular concept when there are different contextual interpretations. Thus, a clear and coherent explanation of the concept of integrated healthcare would be supportive of policymakers and the public and would facilitate the implementation of the integrated approach.