Promising initiatives for integrated service delivery

Objective: Health service users require local services that meet their needs, are connected and easy to navigate. Delivering well integrated and coordinated health care services is challenging. This review aimed to identify integrated care initiatives that improved outcomes for health service users. Methods: A pragmatic literature review was undertaken using a range of electronic databases, websites and grey literature sources. Lessons learned: Diverse models of integrated care have been established across Australia. The most promising initiatives include: Primary Care Partnerships, community-oriented primary health care centres, GP Super Clinics and comprehensive primary health care approaches. The key mechanisms underlying these initiatives are effective communication and support; appropriate structural arrangements, use of technology and tailoring of services to meet local needs. However, many challenges remain, including limited evidence of effectiveness; limited integration with hospitals; poor alignment with other service boundaries; and lack of appropriate measures to evaluate integration efforts. Implications: While evidence from integrated health service delivery projects has demonstrated improved outcomes, experiences and satisfaction for patients, upstream policies and organisational/system initiatives are also needed to enable effective and efficient integrated care at the service delivery level