Tools and Frameworks to Measure Health System Integration
摘要
Integrated care comprises diverse delivery strategies targeting various parts of the healthcare system, while engaging multiple partners in their execution. This poses unique challenges for measuring advances in integrated care. There are many tools that measure individual dimensions of integration with a focus on care coordination and patient-centered care. Fewer tools focus on functional, normative, organization, and system of integrated care despite their importance for successful integration. While useful, current instruments do not capture the complexity and interwoven nature of integrated care as they typically focus on isolated components. Attention in recent years has been on multilevel conceptual integration frameworks covering a range of concepts and target areas. These frameworks are critical to understanding the increasingly complex and multilayered relationships emerging in health systems. However, none of the frameworks offers a unified approach to measurement. We propose that stronger international cooperation needs to occur in the development of the frameworks to promote a coalesced international approach to measurement. Continued progress toward integrated care will depend much on our ability to contrast and compare the impact of strategies across different levels and contexts, using consistent measurement tools.