Evidence for Building an Integrated Dementia Healthcare System: A Systematic Review.

Objectives: Proponents of integrated healthcare systems suggest that such system can improve healthcare experience for individuals with dementia by amalgamating personal and structured resources.

Methods: We assessed systematically available evidence on the current state of integrated healthcare systems viewed in terms of different levels and dimensions of integration, emphasizing multiple stakeholders' simultaneous perspectives. Studies were eligible for inclusion if they (1) evaluated a health system, (2) adopted a network or integrated care model, (3) cared for individuals with dementia, and (4) provided real-world data.

Results: Our review included 31 studies. Main components of the healthcare system included care mediation, multidisciplinary care, primary care integration, long-term care, community-based service, digital technology, and one undefined. Most studies involved meso-level integration (n = 23), followed by micro-level (n = 12) and macro-level integration (n = 5).

Conclusions: Key factors that promote an integrated healthcare system for dementia include supportive organizational structure, multidisciplinary collaboration, effective leadership, clear roles, streamlined referral, and community involvement. Macro-level integration should be considered with greater emphasis in conjunction with both meso- and micro-level integration.

Clinical implications: Successful development of comprehensive integrated healthcare network will require thoughtful implementation and transition across all levels of the system.