Towards a values framework for integrated health services: an international Delphi study.

Area of Science:

• Health Services Research
• Healthcare Management
• Normative Ethics in Healthcare

Background:

• Growing need for person-centered care for individuals with complex health and social needs.
• Transition from fragmented to integrated health services delivery is crucial.
• Understanding factors driving collaboration and decision-making in integrated health services is essential for effective governance.

Purpose of the Study:

• To investigate the underlying values that support integrated health services delivery.
• To assess the relevance of a literature-based set of values across different integration levels.
• To establish a normative basis for integrated care.

Main Methods:

• International Delphi study involving 33 experts from 13 countries.
• Three rounds of expert consensus-building to refine values.
• Assessment of value relevance across personal, professional, management, and system levels of integration.

Main Results:

• A refined set of 18 core values for integrated health services was developed.
• Identified specific values relevant to each integration level (e.g., 'trustful' at personal, 'collaborative' at professional, 'efficient' at management, 'comprehensive' at system).
• Observed both consistent and inconsistent scoring of values across different integration levels.

Conclusions:

• An international normative foundation for integrated health services delivery has been established.
• The identified values can inform the development of a values framework for integrated care.
• Future research should explore practical behaviors, normative integration and governance relationships, and stakeholder value priorities.