Evidence on the Efficacy of Integrated Care

Abstract

The fragmented delivery of healthcare and social services was put on the agenda as a major problem by WHO in 2002. Early Home-Supported Discharge (EHSD) of stroke patients combining efficacy with net savings represents a prototype of integrated care (IC) or overlapping services for better clinical continuity. Other frequent chronic conditions as heart failure, chronic obstructive pulmonary disease and mental disease exhibit parallel results from home health interventions. A SWOT analysis of IC emphasizes: Strengths are 1) economic dominance, 2) benefits to a majority of the population and 3) psychological motivators for the patient (Hawthorne effect) Weaknesses are 1) moderate improvements on a day-to-day basis, 2) some lack of RCT and 3) lack of trust across settings Opportunities are 1) job enrichment to health professionals, 2) low-tech improvements affordable to low and middle income countries and 3) organisational quality Threats are 1) fragmented financial conditions, 2) defensive specialists and 3) Mediocre implementations