Integration in action: four international case studies

ROSEN Rebecca, et al
Nuffield Trust
Publication year:
55p., bibliog.
Place of publication:

The challenge of delivering coordinated, high-quality care is becoming more pressing as the population ages and the prevalence of chronic conditions increases. The challenge for health services will be to try to provide better care coordination and integration across different providers, including across health and social services. This report describes 4 case studies which explore how 4 health care systems, facing similar issues to the NHS, have tried to develop integrated care, focusing on the approaches developed and examining how the policy, financial and regulatory context affects their ability to deliver integrated services. The 4 organisations that were analysed were Community Care North Carolina, USA; Greater Rochester Independent Practice Association, USA; Regionale HuisartsenZorg Huevelland, the Netherlands; and the North Lanarkshire Health and Care Partnership, Scotland. Case study data were collected through semi-structured interviews and document analysis. The focus of the investigation was to identify factors that supported or hindered efforts to develop integrated care. All four sites revealed the influence of 6 sets of operational actions or ‘integrative processes’ that between them acted synergistically and drove progress towards integrated care. These processes are: clinical, organisational, informational, financial, administrative, and normative. Recommendations are provided into how policy and regulation could be developed and implemented to support integration between services.

Subject terms:
integrated services, NHS, social care provision, case studies, health care, government policy;
Content type:
Netherlands, Scotland, United States
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ISBN print:
978 1 905030 44 6

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