Developing and testing an instrument to evaluate integration in Health Care

The aim of this study is to identify the attributes of integration in health care and to build a cluster of indicators to assess the degree of integration based on the elements diagnosed. The study adopted a qualitative mixed-method approach to collect data. First, two rounds of a Delphi study involving health care experts were conducted. Next, an individual in-depth interview (IDI) with the manager of a selected health care network was performed. Our findings suggest that quality-oriented health care integration can be described by nine clusters of indicators: Formal integration, Information integration, Supporting the patients and their environment, Clinical decision support, Patient-centred care, Managing the patient’s "treatment pathway", Cross-sectoral cooperation, Coordination of activities, and Soft elements fostering trust and commitment.

The proposed framework can be used to evaluate the stage of the integration of health care programmes. Therefore, it can be treated as a methodical background for decision support systems (DSS) in health care settings. Moreover, it could be helpful in assessing the quality orientation of health care entities and networks, especially as regards the issues of chronic patients. To the author’s best knowledge, the present study is the first empirical research into the indicators of quality-oriented health care in Poland.