This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.
From micro to macro: Assessing implementation of integrated care in Australia
Many countries and health systems are pursuing integrated care as a means of achieving better outcomes. However, we lack methods for comparing integration approaches across models or settings, and for evaluating whether the key components of integrated care are present in different initiatives. This study attempts to shed light on the implementation of integrated care in Australia, using a new tool to characterize and compare integration strategies at micro, meso, and macro levels. One hundred and fourteen staff from a purposive sample of 38 integrated care projects completed a survey based on the Rainbow Model of Integrated Care. Ten key informants gave follow-up interviews. Participating projects reported using multiple strategies to implement integrated care but descriptions of those strategies were often inconsistent. Micro-level strategies including clinical-professional service coordination and person-centered care were most commonly reported, and a common vision among project staff was described as critical. Performance feedback appeared under-utilized, as did strategies requiring macro-level action such as data linkages or payment reform. The results suggest that Australian integrated care efforts are unevenly weighted towards micro-level strategies. Meaningful macro-level action may warrant consideration in order to advance and sustain the many promising projects currently underway.
PY17024 Accepted 29 August 2017
© La Trobe University 2017