TY - JOUR
KW - Case-Control Studies
KW - Delivery of Health Care, Integrated/organization & administration
KW - Humans
KW - Israel
KW - Nigeria
KW - United Kingdom
KW - United States
KW - Vietnam
KW - EPIS framework
KW - Global healthcare
KW - integrated care
KW - Multiple case study
AU - N. A. Stadnick
AU - E. Sadler
AU - J. Sandall
AU - C. F. Turienzo
AU - I. M. Bennett
AU - J. Borkan
AU - B. Oladeji
AU - O. Gureje
AU - G. A. Aarons
AU - M. Sklar
A1 - 
AB - BACKGROUND: Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. Furthermore, there is a complex interplay of factors at multiple levels of influence that are necessary for successful implementation of integrated care in health systems. METHODS: Guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework (Aarons et al., 2011), a multiple case study design was used to address two research objectives: 1) To highlight current integrated care implementation efforts through seven international case studies that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and 2) To synthesize the shared and unique challenges and successes across studies using the EPIS framework. RESULTS: The seven reported case studies represent integrated care implementation efforts from five countries and continents (United States, United Kingdom, Vietnam, Israel, and Nigeria), target a range of clinical populations and care settings, and span all phases of the EPIS framework. Qualitative synthesis of these case studies illuminated common outer context, inner context, bridging and innovation factors that were key drivers of implementation. CONCLUSIONS: We propose an agenda that outlines priority goals and related strategies to advance integrated care implementation research. These goals relate to: 1) the role of funding at multiple levels of implementation, 2) meaningful collaboration with stakeholders across phases of implementation and 3) clear communication to stakeholders about integrated care implementation. TRIAL REGISTRATION: Not applicable.
AD - Department of Psychiatry, University of California San Diego, La Jolla, USA. nstadnick@ucsd.edu.; Child and Adolescent Services Research Center, San Diego, USA. nstadnick@ucsd.edu.; Health Service & Population Research Department, Centre for Implementation Science, King's College London, London, UK.; Department of Nursing, Midwifery and Health, School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.; Department of Family Medicine, University of Washington, Seattle, USA.; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA.; Department of Global Health, University of Washington, Seattle, USA.; Department of Family Medicine, Brown University, Providence, USA.; Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.; Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.; Department of Psychiatry, University of California San Diego, La Jolla, USA.; Child and Adolescent Services Research Center, San Diego, USA.; Department of Psychiatry, University of California San Diego, La Jolla, USA.; Child and Adolescent Services Research Center, San Diego, USA.
BT - BMC health services research
C5 - Education & Workforce
CP - 1
CY - England
DO - 10.1186/s12913-019-4661-5
IS - 1
JF - BMC health services research
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. Furthermore, there is a complex interplay of factors at multiple levels of influence that are necessary for successful implementation of integrated care in health systems. METHODS: Guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework (Aarons et al., 2011), a multiple case study design was used to address two research objectives: 1) To highlight current integrated care implementation efforts through seven international case studies that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and 2) To synthesize the shared and unique challenges and successes across studies using the EPIS framework. RESULTS: The seven reported case studies represent integrated care implementation efforts from five countries and continents (United States, United Kingdom, Vietnam, Israel, and Nigeria), target a range of clinical populations and care settings, and span all phases of the EPIS framework. Qualitative synthesis of these case studies illuminated common outer context, inner context, bridging and innovation factors that were key drivers of implementation. CONCLUSIONS: We propose an agenda that outlines priority goals and related strategies to advance integrated care implementation research. These goals relate to: 1) the role of funding at multiple levels of implementation, 2) meaningful collaboration with stakeholders across phases of implementation and 3) clear communication to stakeholders about integrated care implementation. TRIAL REGISTRATION: Not applicable.
PP - England
PY - 2019
SN - 1472-6963; 1472-6963
SP - 899
T1 - Comparative case studies in integrated care implementation from across the globe: a quest for action
T2 - BMC health services research
TI - Comparative case studies in integrated care implementation from across the globe: a quest for action
U1 - Education & Workforce
U2 - 31775740
U3 - 10.1186/s12913-019-4661-5
VL - 19
VO - 1472-6963; 1472-6963
Y1 - 2019
Y2 - Nov 27
ER -