Integrated care: an insight into the national models and their impact on patients and health systems – a narrative review
Authors: Correia de Matos Ricardo , do Nascimento Generosa , Campos Fernandes Adalberto 
Published: December 2024

Purpose

Integrated care has emerged as a vital approach to address the growing complexities of healthcare systems worldwide, particularly in managing the increasing prevalence of chronic diseases, aging populations and socioeconomic disparities. Integrated care generally involves the alignment of health and social services to provide patient-centered, coordinated and efficient care, ensuring continuity of care, optimizing resource allocation and improving patient outcomes during crises. Despite these recognized benefits, significant variability exists in how integration is conceptualized and implemented globally. This review aims to explore the diverse definitions, types and implementations of integrated care, comparing international health models and their impacts on patient and system-level outcomes.

Design/methodology/approach

A comprehensive literature review was conducted using PUBMED, MEDLINE, Google Scholar and Science Direct. Eligible studies included original research and reviews without time or regional restrictions. Search terms included “integrated care,” “integrated health and social care” and “integration”. Manual screening of references supplemented data collection. Studies were included based on relevance to the research question, focusing on the definitions, types and national policies regarding integrated care.

Findings

Integrated care models were categorized into vertical, horizontal, functional, clinical and service integration, each with distinct benefits and applications. Integrated care is defined by various authors as collaboration of various pillars of health and social care systems either at administrative, professional or infrastructural levels to obtain optimum health and economic outcomes. Different types of integration have been adopted worldwide depending upon the level of supply chain as well as level of healthcare collaborating with volunteers. Different countries adopted one or more type of integrated care models with some of evidence favoring vertical integration regarding patient outcome. The cost of integrated care in terms of distribution of resources and financial consumption and output may be same or more or less than conventional care model.

Practical implications

Integrated care models enhance patient outcomes, resource efficiency and system-level collaboration. However, barriers such as financial disparities, infrastructural limitations and organizational fragmentation persist. Despite promising examples of integrated care, the evidence on cost benefits remains inconclusive. Recommendations include aligning health and social care budgets, promoting patient-centered care, enhancing inter-professional collaboration and implementing shared electronic health records. Further research is needed to establish cost-effectiveness and refine integrated care policies for better health outcomes and system sustainability.

Originality/value

This is the first review to correlate and compare the national health models of various countries in terms of types of integration of health and social care and to bring out patient and system focused health and financial benefits out of it. Moreover, it gathers almost all the available data on the research question in one review with emphasis on latest approach.