Financial Integration across Health and Social Care:
Helen Weatherly, Anne Mason, Maria Goddard
Centre for Health Economics,
Kath Wright, Centre for Reviews & Dissemination,
Scottish Government Social Research – 2010
Available online PDF [80p.] at: http://bit.ly/i5vx9d
“…………The effective, affordable and sustainable provision of social care is a challenge in many high income countries due to increasing demand and pressure on limited resources. As it is increasingly unsustainable for health care systems to focus on treatment and secondary care, preventive measures and ways to integrate health and social services are being examined.
This report includes a rapid review of the international literature on integrated resource mechanisms used within health care and across health and social care. The review identifies various techniques that have been used to enable financial integration, the context in which they were used, their overall effectiveness, barriers to implementation and critical success factors. Funding models were identified and critically appraised from an economic perspective.
Three reasons for adopting integrated funding approaches were identified. Individuals with complex needs often have difficulty receiving quality care in existing separated structures. Increasing demand for medical care, along with scarce resources and financial pressures, are showing current healthcare systems to be economically unsustainable.
Current financial structures may include incentives that encourage over-supply and discourage disease prevention measures.
While there was no evidence of joint financing leading to an improvement in health outcomes, this may be because the analytic approach used was not appropriate and few studies analysed health outcomes. There is limited evidence on the effectiveness and cost-effectiveness of integrated resource mechanisms.
However this may be due to study design rather than absence of effect.
It is difficult to determine which integrative approaches are the most effective due to the degree of heterogeneity between them. But there is little evidence that structural integration, which involves combining health and health-related social care units into a single health body, is necessary for achieving integration of care…..”
Table of contents
inclusion and exclusion criteria
results of the electronic searches
results from the evidence review
limitations of the review
lessons from the review
Appendix 1: data extraction tables
Appendix 2: search strategies
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