Table 6.
Definitions of primary concept used by authors of included studies.
| Author | Primary term | Definition provided |
|---|---|---|
| Butler (2011) | Integration | At the simplest level, integrated mental and physical health care occurs when mental health specialty and general medical care clinicians work together to address both the physical and mental health needs of their patients. Models of integrated care, sometimes called collaborative care, vary widely, but most include more than merely enhanced coordination of or communication between the clinicians responsible for the mental and physical health needs of their patients. Indeed, attempts to integrate provider roles emphasise parity and mutual respect for the two health components. At the same time, they include efforts to improve the process of care using evidence-based standards of care. |
| Collet (2010) | Integration | Not defined |
| Davies (2011) | Integration | Integration of service provision can be defined as ‘a single system of needs assessment, commissioning and/or service provision that aims to promote alignment and collaboration between the cure and care sectors (Rosen & Ham, 2008). There are different levels of integration between healthcare services (Kodner & Spreeuwenberg, 2002). In the context of integrated working with care homes, these can be summarised as: Patient/micro-level close collaboration between different healthcare professionals and care home staff, e.g. for the benefit of individual patients. Organisational/meso-level organisational or clinical structures and processes designed to enable teams and/or organisations to work collaboratively towards common goals (e.g. integrated health and social care teams). Strategic/macro-level integration of structures and processes that link organisations and support shared strategic planning and development, e.g. when healthcare services jointly fund initiatives in care homes (Bond, Gregson, & Atkinson, 1989 and The British Geriatrics Society, 1999). |
| Donald (2005) | Integration | There is considerable diversity concerning the definition of integration, and the extent of integration varies enormously across different studies and settings. For example, it is used to refer to treatment provided both by multi-professional teams and by individual providers. In general, integrated approaches refer to those where both the mental health disorder and the addictive disorder are treated simultaneously. Typically, this is regarded as requiring the treatment to take place within the same service by the same clinician. The nature of the integrated treatment should also be considered. If integration merely involves augmentation through the addition of either a standard mental health treatment component or a standard drug and alcohol treatment component, then it may be argued that this is not truly integrated. Rather it may be that an integrated treatment would directly acknowledge and address the presence of the comorbidity in terms of the tailoring of the treatment to the current status of the person and would treat the co-occurring nature of the disorders, which may involve making adjustment in one treatment to take account of the other. |
| Dowling (2004) | Partnership | For the purposes of the present article, the authors adopted the Audit Commission’s (1998) definition of partnership as a joint working arrangement where partners are otherwise independent bodies cooperating to achieve a common goal; this may involve the creation of new organisational structures or processes to plan and implement a joint programme, as well as sharing relevant information, risks and rewards. This definition is compatible with a wider range of terms than ‘partnership’, including similar terms such as ‘cooperation’ and ‘collaboration’. |
| Fisher (2012) | Integration | Not defined |
| Fleury (2006) | Integration | To paraphrase Leutz (1999) the term integration has put forward a large number of models concerning the organisation of services or types of intervention. All refer to ‘anything from the closer coordination of clinical care for individuals to the formation of managed care organisations that either own or contract for a wide range of medical and social support services’. |
| Green (2014) | Collaboration | Not defined |
| Grenfell (2013) | Integration | Not defined |
| Hillier (2010) | Collaboration | Not defined |
| Howarth (2006) | Integration | Not defined |
| Hussain (2014) | Integration | Collaborative or integrated mental health care has been defined as care delivered by general medical physicians working with psychiatrists and other allied health professionals to provide complementary services, patient education and management to improve mental health outcomes (Katon, Von Korff, & Lin, 1995). Integrated models of care are patient-centred, and they not only involve the psychiatrist as a consultant with co-location of psychiatric and medical services but also involve a shared responsibility for the care of all patients within a service. |
| Lee (2013) | Collaboration | Not defined |
| Loader (2008) | Integration | Not defined |
| Soto (2004) | Integration | For the purpose of this review, we offer the following working definition: Integrated HIV care combines HIV primary care with mental health and substance-abuse services into a single coordinated treatment programme that simultaneously, rather than in parallel or sequential fashion, addresses the clinical complexities associated with having multiple needs and conditions. |
| Winters (2015) | Collaboration | Craven and Bland (2006) ‘involving providers from different specialties, disciplines, or sectors working together to offer complementary services and mutual support, to ensure that individuals receive the most appropriate service from the most appropriate provider in the most suitable location, as quickly as necessary, and with minimal obstacles’. |
Craven MA, Bland R. Better practices in collaborative mental health care: an analysis of the evidence base. Can J Psychiatry Revue Canadienne De Psychiatrie 2006; 51: 7S–72S.
Leutz WN. Five laws for integrating medical and social services: lessons from the United States and the United Kingdom. Milbank Quart 1999; 77: 77–110.
Rosen R, Ham C: Integrated Care: Lessons from Evidence and Experience. The Nuffield Trust for Research and Policy Studies in Health Services; 2008.
Kodner DL, Spreeuwenberg C: Integrated care: meaning, logic, applications, and implications – a discussion paper. International journal of integrated care 2002, 2[1]: 1–6.
Bond J, Gregson BA, Atkinson A: Measurement of Outcomes within a Multicentred Randomized Controlled Trial in the Evaluation of the Experimental NHS Nursing Homes. Age and Ageing 1989, 18: 292–302.
British Geriatrics Society: The Teaching Care Home – an option for professional training. Proceedings of a Joint BGS and RSAS AgeCare Conference held in February 1999 [http://www.bgs.org.uk/PDF%20Downloads/teaching_care_homes.pdf], accessed 080311.
Katon W, VonKorff M, Lin E, et al: Collaborative management to achieve treatment guidelines Impact on depression inprimarycare. JAmMedAssoc1995; 273: 1026–1031. Audit Commission [1998] A Fruitful Partnership: Effective Partnership Working. Audit Commission, London.