What Is Integrated Care?

  • Nicholas GoodwinEmail author
  • Viktoria Stein
  • Volker Amelung


The future sustainability of health and care systems is being challenged by fundamental shifts in demographics and disease status. As the ability to care becomes ever more complex and costly, integrated care has gathered momentum as an international response to these challenges in both policy and practice. Yet, the logic and meaning of integrated care remains contested. This chapter, therefore, seeks to respond to the commonly asked question ‘what is integrated care?’ It examines the rationale that lies behind integrated care and how it is defined. The chapter reviews the building blocks and dynamics of integrated care systems, including key models and concepts, and concludes with some forward thinking on integrated care as an evolving science.


  1. 6 P, Goodwin, N., Peck, E., & Freeman, T. (2006). Managing networks of 21st century organizations. Basingstoke: Palgrave-McMillan.Google Scholar
  2. Ahgren, B., & Axelsson, R. (2005). Evaluating integrated health care: A model for measurement. International Journal of Integrated Care, 5(3), e01.CrossRefGoogle Scholar
  3. Armitage, G., Suter, E., Oelke, N., & Adair, C. (2009). Health systems integration: State of the evidence. International Journal of Integrated Care, 9(2), 1–11.CrossRefGoogle Scholar
  4. Barr, S., Robinson, S., Marin-Link, B., & Salivaras, S. (2003). The expanded chronic care model: An integration of concepts and strategies from population health promotion and the Chronic Care Model. Hospital Quarterly, 7(1), 73–82.Google Scholar
  5. Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The triple aim: Care, health, and cost. Health Affairs (Millwood), 27(3), 759–769.CrossRefGoogle Scholar
  6. Blomfield, M., & Cayton, H. (2009). Community engagement: A report for the Health Foundation. London: The Health Foundation.Google Scholar
  7. Comas-Herrera, A., & Wittenberg, R. (Eds.) (2003). European study of long-term care expenditure. Report to the European Commission, Employment and Social Affairs DG. Personal Social Services Research Unit, London School of Economics, London. PSSRU Discussion Paper 1840.Google Scholar
  8. Contandriapoulos, A., Denis, J. L., Touati, N., & Rodriguez, C. (2003). The integration of health care: Dimensions and implementation. Retrieved from
  9. Curry, N., & Ham, C. (2010). Clinical and service integration: The route to improved outcomes. London: The King’s Fund.Google Scholar
  10. European Commission and Economic Policy Committee. (2009). 2009 Ageing Report: Economic and budgetary projections for the EU-27 Member States (2008–2060). Luxembourg: Office for Official Publications of the European Communities.Google Scholar
  11. Ferrer, L. (2015). Engaging patients, carers and communities in the provision of coordinated/integrated health services: Strategies and tools. Copenhagen: WHO Regional Office for Europe.Google Scholar
  12. Goodwin, N. (2013a). Understanding integrated care: A complex process, a fundamental principle. International Journal for Integrated Care, Jan–Mar, URN:NBN:NL:UI:10-1-114416.
  13. Goodwin, N. (2013b). How do you build programmes of integrated care? The need to broaden our conceptual and empirical understanding. International Journal for Integrated Care, Jul–Sep, e040.Google Scholar
  14. Goodwin, N., & Alonso, A. (2014). Understanding integrated care: The role of information and communication technology. In S. Muller, I. Meyer, & L. Kubitschke (Eds.), Beyond Silos: The way and how of eCare. Hershey, PA: IGI Global.Google Scholar
  15. Goodwin, N., & Smith, J. (2012). The evidence base for integrated care. London: The King’s Fund.Google Scholar
  16. Goodwin, N., Sonola, L., Thiel, V., & Kodner, D. (2013). Co-ordinated care for people with complex chronic conditions. Key lessons and markers for success. London: The King’s Fund.Google Scholar
  17. Goodwin, N., Dixon, A., Anderson, G., & Wodchis, W. (2014). Providing integrated care for older people with complex needs. Lessons from seven international case studies. London: The King’s Fund.Google Scholar
  18. Ham, C., & Walsh, N. (2013). Making integrated care happen at scale and pace: Lessons from experience. London: The King’s Fund.Google Scholar
  19. International Journal of Integrated Care (IJIC). (no date). IJIC guidelines for research and theory papers. Retrieved from
  20. Kodner, D., & Spreeuwenberg, C. (2002). Integrated care: Meaning, logic, applications and implications – a discussion paper. International Journal of Integrated Care, 2(14), e12.Google Scholar
  21. Leichsenring, K., Billings, J., & Nies, H. (Eds.). (2013). Long-term care in Europe. Improving policy and practice. Palgrave Macmillan: Basingstoke.Google Scholar
  22. Leutz, W. (1999). Five laws for integrating medical and social services: Lessons from the United States and the United Kingdom. The Milbank Quarterly, 77(1), 77–110.CrossRefGoogle Scholar
  23. Lewis, R., Rosen, R., Goodwin, N., & Dixon, J. (2010). Where next for integrated care organisations in the English NHS? London: The Nuffield Trust.Google Scholar
  24. National Committee for Quality Assurance. (2016, September). Latest evidence: Benefits of NCQA patient-centred medical home recognition. Washington: NCQA.Google Scholar
  25. National Voices. (no date). A narrative for person-centred coordinated (‘integrated’) care. National Voices. Retrieved from
  26. National Voices. (2011). Webs of Care. What does care look like from the individual's perspective? London: National Voices. Available at:
  27. Nolte, E., & McKee, M. (2008). Integration and chronic care: A review. In E. Nolte & M. McKee (Eds.), Caring for people with chronic conditions: A health system perspective (pp. 64–91). Maidenhead: Open University Press.Google Scholar
  28. Ross, S., Curry, N., & Goodwin, N. (2012). Case management. What it is and how it can best be implemented. London: The King’s Fund.Google Scholar
  29. Shaw, S., Rosen, R., & Rumbold, B. (2011). What is integrated care? London: The Nuffield Trust.Google Scholar
  30. Singh, D., & Ham, C. (2006). Improving Care for people with long-term conditions. A review of UK and international frameworks. Health Services Management Centre, University of Birmingham, Birmingham.Google Scholar
  31. Starfield, B. (2002). Policy relevant determinants of health: An international perspective. Health Policy, 60, 201–218.CrossRefGoogle Scholar
  32. Suter, E., Oelke, N., Adair, C., Waddell, C., Armitage, G., & Huebner, L. (2007 October). Health Systems Integration. Definitions, processes & impact: A research synthesis. Ottawa, ON: Canadian Institutes of Health Research (CIHR).Google Scholar
  33. Suter, E., Oelke, N., Lima, M., Vliet-Brown, C., Hepp, S., & Stiphout, M. (2015). Indicators and measurement tools for health system integration: Results from a knowledge synthesis. International Journal of Integrated Care, 4, 99.Google Scholar
  34. The Health Foundation. (2011). Evidence: Helping people help themselves. London: The Health Foundation.Google Scholar
  35. The Health Foundation. (2012). Leading the way to shared decision making. London: The Health Foundation.Google Scholar
  36. Valentijn, P. (2016). Rainbow of chaos. A study into the theory and practice of integrated primary care. Dissertation, Tilburg University, The Netherlands.Google Scholar
  37. Valentijn, P. P., Schepman, S. M., Opheij, W., & Bruijnzeels, M. A. (2013). Understanding integrated care: A comprehensive conceptual framework based on the integrative functions of primary care. International Journal of Integrated Care, 13, e010.CrossRefGoogle Scholar
  38. Wagner, E., et al. (1999). Improving chronic illness care: Translating evidence into action. Health Affairs, 20(6).Google Scholar
  39. World Health Organization. (1978). Declaration of Alma-Ata, International Conference on Primary Health Care 1978. Geneva: World Health Organization.Google Scholar
  40. World Health Organization. (2002). Innovative care for chronic conditions. Building blocks for action. Geneva: World Health Organization.Google Scholar
  41. World Health Organization. (2008). Primary health care: Now more than ever. World Health Report. Geneva: World Health Organization.Google Scholar
  42. World Health Organisation. (2015). WHO global strategy on people-centred and integrated health services: Interim report. Geneva: World Health Organization.Google Scholar
  43. World Health Organisation. (2016, April 15). Framework on integrated, people-centred health services. Report by the Secretariat, 69th World Health Assembly, World Health Organisation, Geneva.Google Scholar
  44. WHO Regional Office for Europe. (2016). Towards people-centred health systems: An innovative approach for better health systems. Copenhagen: WHO Regional Office for Europe.Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Nicholas Goodwin
    • 1
    Email author
  • Viktoria Stein
    • 1
  • Volker Amelung
    • 2
  1. 1.International Foundation for Integrated CareWolfson CollegeOxfordUK
  2. 2.Institute for Epidemiology, Social Medicine and Health System Research, Medical School HannoverHannoverGermany

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