Table 1.

Description of Rainbow model of integrated care

Clinical integration refers to the coherence in the primary process of care delivery to individuals. It requires a person-focused perspective and includes the aspect of the clients as co-creators in the care process and shared responsibility between professional and client.

Professional integration refers to partnerships between professionals both within and between organisations. These partnerships can be characterised as forms of horizontal and/or vertical integration. To deliver a comprehensive continuum of care, professionals have to share accountability, problem solving and decision-making. As a consequence of this process the professional autonomy is affected and the traditional hierarchy and defined roles become diffused.

Organisational integration refers to the extent that services are delivered in a linked-up way. It is necessary to deliver population-based care because of the collective responsibility for the health and wellbeing of a population. Population-based care can be achieved through hierarchical governance structures, network-like governance mechanisms or through marked based governance structures between organisations. In the field of primary care, organisational integration is often realised in a network construction. These complex network arrangements require effective mechanisms of governance and accountability.

System integration refers to integration of a health system to realise a holistic approach. It requires a tailor-made combination of structures and processes to fit the needs of people across the continuum of care. Both horizontal and vertical integration are needed to counteract the fragmentation and should be incorporated to provide coordinated care across the entire care continuum.

Functional integration supports clinical, professional, organisational and system integration and includes coordination of key support functions as human resources, strategic planning, information management, financial management and quality improvement. Functional integration is the linking of information, management and financial systems around the primary process of service delivery.

Normative integration also achieves connectivity. It can provide a common frame of reference, necessary for providing a continuum of care when various actors are in involved [3].