Integrated care

Integrated care, also known as integrated health, coordinated care, comprehensive care, seamless care, or transmural care, is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision. Integrated care may be seen as a response to the fragmented delivery of health and social services being an acknowledged problem in many health systems. Integrated care, also known as integrated health, coordinated care, comprehensive care, seamless care, or transmural care, is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision. Integrated care may be seen as a response to the fragmented delivery of health and social services being an acknowledged problem in many health systems. Integrated care covers a complex and comprehensive field, and there are many different approaches to and definitions of the concept. WHO gives the following definition: 'Integrated care is a concept bringing together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion. Integration is a means to improve services in relation to access, quality, user satisfaction and efficiency.' The integrated care literature distinguishes between different ways and degrees of working together and three central terms in this respect are autonomy, co-ordination, and integration. While autonomy refers to the one end of a continuum with least co-operation, integration (the combination of parts into a working whole by overlapping services) refers to the end with most co-operation and co-ordination (the relation of parts) to a point in between. Distinction is also made between horizontal integration (linking similar levels of care like multiprofessional teams) and vertical integration (linking different levels of care like primary, secondary, and tertiary care).