J Health Serv Res Policy January 16, 2015 1355819614566832
- The evidence base for integrated care consistently identifies financial factors as a major barrier to successful delivery, A study from the Centre for Health Economics (University of York) used a framework based on agency theory to examine the role that integrated funding can play in promoting coordinated care, where an agency relationship is said to exist whenever there is an element of delegated decision making, such as in healthcare.
- This review found that the case for integrated funding has not yet been demonstrated. No scheme demonstrated a sustained reduction in hospital use, although there was some evidence that care could be shifted into the community and access to services improved. Only a small fraction of the schemes included in the review delivered significant improvements in health outcomes.
- A systematic review of the literature identified 38 schemes from eight countries in 68 published studies that involved integrated financing for health and social care.. Studies based in the UK were predominantly qualitative and/or uncontrolled evaluations.
