Table 1. Experience with integrated health care for older people, worldwide, 1999–2016.

Country and programme	Principle features of integrated care programmea	Results
Australia: coordinated care trials42,43	(i) Whole population approach, which encompassed improvements in access to, and in the delivery of, primary health-care services and in care coordination within the community; (ii) care coordination for people with chronic and complex needs; (iii) information management and technology; and (iv) the creation of robust mechanisms to resolve conflicts.	(i) Clients felt supported and less anxious and general practitioners were very satisfied; (ii) fewer emergency department visits and shorter hospital stays; and (iii) fewer referrals to community health services.
Brazil: Ageing in the National Family Health Programme (case study)b	(i) Home visits undertaken by a multidisciplinary team comprising a doctor, nurse and social worker; (ii) health workers were trained to assess frailty and functioning; and (iii) strong referral links to primary health-care clinics were established.	(i) Results have not yet been documented.
Canada (Province of Quebec): Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA)44	(i) Coordination between decision-makers and managers; (ii) single entry point to care; (iii) case management; (iv) individualized service plans; (v) single assessments; (vi) focus on clients’ functional autonomy; and (vii) computerized clinical chart for communicating between institutions on client monitoring.	(i) Increased client satisfaction and empowerment; (ii) lower incidence of functional decline; (iii) fewer unmet needs; (iv) fewer emergency department visits and hospitalizations; (v) no increase in consultations with health professionals or in the need for home care services; and (vi) better system performance at no additional cost.
Thailand: “Friends Help Friends” project (case study)c	(i) Long-term care lead by the health ministry; (ii) support for informal carers who are providing long-term care; (iii) informal carers and community volunteers are formally engaged in the system and carry out home visits and functional assessments; and (iv) a health professional linked to the nearby health centre provides supervision and logistic support.	(i) Results have not yet been documented.
United Kingdom (England): case study programmes42	(i) Real integration involving vertical integration (i.e. hospital to home) and horizontal integration (i.e. multidisciplinary teams); (ii) people in the community with complex needs targeted; (iii) multidisciplinary teams comprising care coordinators, community nurses, occupational therapists, physiotherapists and social workers; and (iv) funds from National Health Service clinical commissioning group and local authority are pooled.	(i) Increased staff motivation and positive evaluations from general practitioners; (ii) shorter waiting times before receiving long-term care support; (iii) fewer emergency admissions; (iv) fewer bed days and shorter hospital stays; (v) fewer residential home placements; and (vi) better system performance at no additional cost.

^a Information was obtained from the World report on ageing and health.¹

^b Eduardo Augusto Duque Bezerra, Pernambuco State Health Secretary, Personal communication, 2015.

^cEkachai Piensriwatchara and Puangpen Chanprasert, Department of Health, Ministry of Public Health, Thailand, Personal communication, 2015.