What is successful integrated community care? A systematic literature review.

Abstract

Introduction: The ageing process vastly impacts the need for care and support, as it is often associated with a decrease in health and function. Governments of ageing populations are using “ageing in place” as the main policy perspective, in which people receive care and support in their personal environment. Although great value is within this perspective, recent studies accentuate that the location where people live vastly impacts their need for care and support. This highlights the need for the development of new, long-term care systems to address these challenges. Scholars argue that the issue can be resolved by implementing locally, integrated and community-based health and social care. Integrated community care (ICC) has been defined as a range of strategies to support multiple stakeholders to co-develop and health, care and social support services and infrastructures, aiming to achieve several goals. However, it is unclear of which key elements ICC consists of. 
 Method: The main goal of this systematic literature review was to identify the key elements which successful ICC consists of. We searched five electronic databases with several search strings which we defined as closely related to, a part of or the same as ICC based on the preliminary results of the literature review. A total of 65 articles were included in the review based on eligibility criteria, divided into two groups. The first group included twenty articles mentioning ICC or one of the search strings in the title or abstract, the second group contains forty-five articles linked to ICC but clearly focus on a different issue or topic. Thematic analysis was used to code the articles. 
 Results: Eight key elements of integrated community care were identified, namely: (1) asset-based, (2) person-centred, (3) co-development, (4) governance, (5) locality, (6) improvement of mental and physical health, (7) improvement of the existing health care system, (8) tackling determinants of health. Different perspectives and possible difficulties related to these elements were discussed. 
 Discussion: We identified eight key elements of ICC, dealing with the starting point (asset-based and person-centred), strategies and stakeholders (co-development, governance, locality) and aims or ambitions (improvement of mental and physical health, improvement of the existing health care system, and tackling health determinants). However, it is still unclear how these elements correlate with each other. Some of these key elements remain rather vague or abstract. Further research should focus on formulating specific definitions for these elements in the context of ICC as well as codifying ways to implement these key elements in practice.