How is Integration Defined and Measured, and what Factors Drive Success in Brazil? An Integrative Review

Area of Science:

• Health Services Research
• Health Policy
• International Health

Background:

• Integrated care delivery is crucial for improving health and care quality but faces significant challenges.
• In lower and middle-income countries, particularly in Latin America, integrated care systems are still under development.

Purpose of the Study:

• To review existing literature on integrated care within Latin American countries.
• To understand how integration is identified and measured.
• To identify factors influencing the success of integrated care implementation.

Main Methods:

• An integrative literature review was conducted.
• Searches included Global Health, PubMed, SciELO, and BVSPsi databases (1999-2020).
• Articles were screened and assessed by five independent reviewers based on inclusion criteria for health care systems integration.

Main Results:

• Twenty-four articles were included, primarily qualitative research from Brazil.
• A lack of consensus on the definition and measurement of integrated care was noted, with interchangeable use of terms.
• Key barriers identified include lack of shared understanding, unclear professional roles, power struggles, and insufficient institutional support.

Conclusions:

• Various integration types and success factors were identified in Brazilian contexts.
• The concept of integration varies significantly across local and regional realities.
• Further clarification of integrated care's objectives and components is needed, especially in lower and middle-income countries (LMICs).