Towards a comprehensive understanding of Integrated Community Care (ICC)

Abstract

Introduction: Health and functional decline in older people greatly affects their need for care and support. Governments, when confronted with ageing populations, therefore use the policy perspective of ‘ageing in place’, which supports social and health care in the personal environment of people. Recent studies also accentuate the influence of the location in which people live on their health and social care needs. One possible way to implement social and health care in localities is by integrated community care (ICC) or caring neighbourhoods. In Flanders (Belgium), we see a couple of initiatives and policy using the concept of ICC. Although internationally there is progressively more attention towards this concept, there is virtually no agreement between scholars on what exactly it entails. This study aims to develop a framework for a better understanding of ICC by providing insight in its objectives and critical success factors. This framework can be used by initiators of ICC projects and policy makers to develop ICC projects and to formulate policy recommendations. 
 Method: The study consisted of five focus groups with stakeholders of ICC to identify the objectives and critical success factors. Two main groups of stakeholders were defined in Flanders and Brussels: (1) stakeholders with experiences regarding ICC, and (2) academic experts or policy makers of the Flemish or Brussels’ Government. The first group was questioned using the Multi-actor multi-criteria analysis method (Macharis et al., 2012). The second group reflected on the results of the first focus groups, using a semi-structure interview scheme. The results of the descriptive thematic analysis were compared and combined with key elements of ICC, as found in a review of academic and grey literature.
 Results: The five focus groups with the stakeholders led to the identification of objectives and critical success factors. We identified two sets of objectives: (i) process goals; and (ii) operational objectives, or effective objectives. For every objective, accompanying and general critical success factors were formulated. All objectives can be connected to key elements of ICC found in literature, dealing with methods or strategies, goals or ambitions and stakeholders. The presence of involved stakeholders was mostly cited in the critical success factors. The effective objectives correspond with the goals formulated in literature, however, there are some differences. In literature they focus heavily on social and health care, while goals formulated by the stakeholders target mainly social and societal changes.
 Conclusion: Focus groups allowed to define a clear set of stakeholder objectives that determine the success of ICC. The use of the Multi-actor multi-criteria analysis method allowed to build a framework that enable both practitioners and scholars to understand which quantitative and qualitative factors contribute to the success of an ICC project. Future research is needed to understand the relative importance of each factor and objective and how it contributes to the success of ICC. 
 Reference: 
 Macharis, C., Turcksin, L., & Lebeau, K. (2012). Multi actor multi criteria analysis (MAMCA) as a tool to support sustainable decisions: State of use. Decision Support Systems, 54(1), 610-620. https://doi.org/10.1016/j.dss.2012.08.008