Shifting paradigms: Developmental milestones for integrated care

Area of Science:

• Health Services Research
• Organizational Studies
• Primary Health Care

Background:

• Existing integrated care frameworks often overlook local contextual complexities.
• Understanding the developmental trajectory of integrated care is crucial for effective implementation.

Purpose of the Study:

• To propose a novel strategy for conceptualizing integrated care development through organizational milestones.
• To present an empirically generated typology of these milestones from case studies.

Main Methods:

• Analysis of 28 interviews with managers and leaders from four integrated community-based primary health care (ICBPHC) case studies in Canada and New Zealand.
• Development of timelines and synthesis of themes to identify specific milestone events and categories.

Main Results:

• A typology of 5 milestone categories (strategic relational, strategic process change, internal structural, inter-organizational structural, external) comprising 12 specific events was generated.
• These milestones provide a framework for understanding the phased development of integrated care.

Conclusions:

• A milestone-based framework offers a compelling strategy for conceptualizing integrated care development.
• Policymakers and leaders can use this framework to identify strategies for accelerating integrated care implementation by examining local context and history.