Communities as co-producers in integrated care.

Area of Science:

• Health Services Research
• Sociology of Health
• Public Health Policy

Background:

• Integrated care models predominantly reflect professional perspectives, neglecting the significant role of non-professionals.
• Current integrated care debates in high-income countries are heavily influenced by professional norms and values.
• The majority of care provision, especially for individuals with complex needs, relies on non-professional support.

Purpose of the Study:

• To challenge existing paradigms of integrated care by emphasizing the role of non-professional caregivers and communities.
• To advocate for the incorporation of community resources and non-professional contributions as co-producers of care.
• To explore the necessary transformations in professional responsibilities, organizational structures, and funding models for effective integrated care.

Main Methods:

• Conceptual analysis and theoretical argumentation regarding the role of non-professionals in integrated care.
• Examination of the blurring boundaries between formal/informal care and public/private spheres.
• Discussion of policy, legislative, and funding implications for integrating community-based care resources.

Main Results:

• Reconsidering integrated care necessitates redefining professional and non-professional roles, blurring public/private and formal/informal care distinctions.
• Organizational boundaries require renegotiation, impacting legislation, funding, professional qualifications, and governance structures.
• Successful integrated care hinges on recognizing citizens within their social networks and local communities as essential co-producers of care.

Conclusions:

• Integrated care must evolve beyond a professional-centric concept to embrace community and non-professional co-production.
• Transforming professional identities, service user roles, and funding mechanisms (e.g., social impact bonds) is crucial.
• Addressing integrated care challenges at the community and citizen level is essential for achieving genuinely integrated care outcomes.