Why Do We Need Integrated Care?

Abstract

The common and central goal in integrated care initiatives is easily accessible, seamless, highly coordinated care—from a patients perspective. This quest to optimize the interface between different sectors and professional groups has at its core the following elements: the provision of the right care, at the right time, by the appropriate service provider, in a timely manner, irrespective of organizational boundaries or financial flows. We explain that a move towards a more integrated system of care is needed in order to contribute to achieving the quadruple aim: to boost the quality of healthcare, to increase cost efficiency, to promote public health, and to improve the quality of working life of the care teams and individual care providers. We argue that the still most unused lever for achieving integrated care lies in looking at the possibilities offered in the redesign of the way in which the management functions and work processes of care systems are organized. We argue that organizing care in a manner that contributes to fulfilling the Quadruple Aim is both desirable and possible. We describe the high level of fragmentation which can be found in many care systems, and we conclude that merely adding coordination mechanisms to a highly fragmented systems is likely to lead to more complexity even if it increases the level of integrated care. What is needed is a redesign of the care system structure.