Integration

Care integration promises innovative, proactive and person-centred care and can help face the challenge of rising (multiple) chronic diseases in more cost-effective ways. But how do we get there? This page showcases some of the European Observatory's work around health systems integration.

Integrated care can be defined as organizations and staff working together across professional and institutional boundaries to provide patient centered and seamless care. It involves the joint development of flexible and continuous care processes and care pathways. It tackles the overarching issues around linking different sectors, including non-health sectors like social care, and the practical tools and strategies that enable work across health care delivery boundaries.

The goal is to move away from reactive and hospital-centric models of care towards more innovative, proactive, primary care-led and integrated models. It also responds to the need to move from a disease-focused approach to a person-centred approach, addressing demands that patients be more central to shaping care and for ways of addressing the rising incidence of chronic disease and multi-morbidity in more cost-effective care settings. 

Care integration cuts across the full range of the Observatory’s research portfolio, with a range of studies on health care delivery and integration of care, from the first Observatory studies focused on a more effective role for the hospital and the need to put primary care in the driver’s seat to the role of the hospital of the future. More recently, work has also concentrated on innovative models for integrated care, home care and managing people living with multiple chronic diseases across different levels of care.

Key strategies to achieve coordinated care have also been addressed with studies on payment systems and skill mix for primary and community care; wide ranging case studies on skill mix innovations and best practices; and policy briefs on eHealth, financing and patient empowerment mechanisms. Various Observatory activities, including policy dialogues, Summer Schools on ‘integrated care’ and ‘primary care innovation for integrated care’, and a special issue of Health Policy on multimorbidity, emphasize the value of aligning disciplines, models, mechanisms and incentives to strengthen integration. 

The Observatory focuses on new work strands that address the complex mix of factors explaining the persistent blocks to care integration across different levels, with a particular focus on patient centeredness,  the inappropriate skill mix; the weaknesses of primary and community care; and the lack of financial and other incentives. Key to this is looking at implementation strategies that can help scale effective integrated care, taking into account specific conditions on the ground.