Table 1.

A Taxonomy of Integrated Care Literature

Key Perspectives	Main Focus of Papers	Lines of Argument a
Patients’ Perspectives of Integrated Care (9 papers)
Redding, 2013; Reinhard, 2013	Eliciting patient's perspectives through consultation and focus groups.	Patients value person‐centered coordinated care, being able to control and plan their care, communication, continuity of care, and practical and emotional support.
Gowing et al., 2016; Greenfield et al., 2014; Hudon et al., 2015; Sargent et al., 2007; Spoorenberg et al., 2015	Subjective experiences of integrated care, including patients’ perspectives of integrated care programs, multidisciplinary case management, and satisfaction with care provided.	Reassurance and psychosocial support are important to patients and carers (but are not necessarily included in official guidance). For care to be person‐centered, patients need to be considered as active subjects.
Singer et al., 2011; Vrijhoef et al., 2009	How to conceptualize and measure integrated care from the patient perspective.	The object of integration should be patient care (as opposed to organizational integration), with patient centeredness as a key element. Measures of patients’ experiences and satisfaction of services can be undertaken through validated survey instruments.
Organizational Strategies and Policies to Integrate Care (46 papers)
Case Management (12 papers)
Baker, Grant, and Gopalan, 2018; Huntley et al., 2013; Reilly, Hughes, and Challis, 2010; Stokes et al., 2015	Evidence reviews: systematic reviews and meta‐analyses of the effectiveness of case management for multimorbidity and high service utilization, hospital admissions for older people, and “at‐risk” patients in primary care, and literature review of the implementation and processes of case management.	There is little evidence of effectiveness of case management on health care utilization or in reducing hospital admissions, and some evidence of improvement in patient‐reported outcomes.
Boaden et al., 2005; Carrier, 2012; Gravelle et al., 2006; Kane et al., 2003; Sheaff et al., 2009	Evaluation and research of case management, including the Evercare model in the United States and the United Kingdom;practice of case management in Canada and the United Kingdom.	The Evercare model of case management found to prevent hospitalizations and be cost‐effective in the United States was piloted in the United Kingdom but did not have the same effects. Case management practices were shaped by context of home care, size of caseloads, and availability of resources; although valued by patients and carers, little system change resulted from case management practices.
UK Department of Health, 2005; Ross, Curry, and Goodwin, 2011; NHS England, 2016	Policy and guidance on case management in the English NHS.	Case management needs to be targeted and proactive to be cost‐effective, being most effective when implemented as part of a wider program of integrated care.
Multidisciplinary Working (8 papers)
Harris et al., 2012; Harris et al., 2013; Janse et al., 2016a; Janse et al., 2016b; Kassianos et al., 2015; Lusardi and Tomelleri, 2017; Raine et al., 2014; Tousijn and Willen, 2012	Primary research into the processes and effects of multidisciplinary team/group working, including extent and intensity of integration in multidisciplinary groups, experiences and perspectives of professionals, team relationships, and effect of multidisciplinary teams on implementation of treatment plans.	Multidisciplinary working is central to interventions to integrated care, with evidence of effectiveness in integrating care but with limited evidence of measurable effects of such integration on patients or system outcomes. Multidisciplinary working increases workload for professionals in terms of non‐patient‐related care, can have beneficial effects for professionals, has some effects on interprofessional relationships, and does not necessarily equate to more collaborative decisions or actions being implemented.
Linking Organizations (14 papers)
Coordination Technologies
Ahgren and Axelsson, 2011; Allen, Gillen, and Rixson, 2009; Haland and Rosstad, 2015	Policy analysis of chains of care in Sweden; systematic review of effectiveness of integrated care pathways (who they are effective for and in what circumstances); qualitative research of care pathways integrating primary and secondary care.	Care pathways and chains of care coordinate activities for patients/groups of patients across organizational boundaries, comply with best clinical practice, and distribute work required to support patients/groups of patients with complex needs.
Partnership Working
Barker, 2014; Glasby, Dickinson, and Miller, 2011; Shaw and Rosen, 2013	Policy analysis of health and social care funding and partnership working in English settings and policy analysis of fragmentation.	Partnership working enables organizations to strategically address common concerns requiring multiagency solutions.
Macadam, 2015; Rudkjobing et al, 2014	Examples of interorganizational coordination in Canada (networked governance model) and Denmark (health care agreements).	Partnership working facilitates joint working between organizations through agreements and governance arrangements without merging or otherwise changing organizational structures.
Collective Accountability
Hwang et al., 2013; Ramsay, Fulop, and Edwards, 2009	Reviews of evidence of effects of Integrated Delivery Systems on cost and quality evidence base for vertical integration in health care.	Integrated delivery systems have been introduced in the US setting to address concerns of fragmentation, cost, and variation in quality of care. Vertical integration can enable capture of cost savings that are related to providing upstream/preventive care.
McCarthy et al., 2009; Ovretveit, Hansson, and Brommels, 2010	Case studies of Kaiser Permanente and Norrtalje, Sweden.	Kaiser Permanente is an example of a successful integrated delivery system in terms of competitiveness in the health care market, and providing high quality for low cost and low use of hospital beds. Norrtaljie is an example of an integrated public health and social system influenced by a range of organizational and contextual factors.
Farmanova, Baker, and Cohen, 2019; King's Fund, 2018	Scoping review of strategies to develop integrated and population‐health‐focused health systems and policy review of accountable care proposals for England.	Integration of services can be combined with population health approaches; accountable care organizations and integrated delivery systems are forms of integration that can improve health outcomes at the population level.
Whole System Approaches (12 papers)
Baxter et al., 2018; Beland and Hollander, 2011; Johri, Beland, and Bergman, 2003; Ouwens et al., 2005; Martinez‐Gonzalez et al., 2014	Evidence reviews (systematic review, evidence synthesis, review of systematic reviews and metareview) of effects of models of integrated care for frail, elderly, and adults with chronic conditions.	Strategies to integrate care for patients need to be supported by organizational, workforce, financial, and systems changes in a programmatic or whole system approach. Methodological problems arise in evaluating and comparing multifaceted/whole system programs in diverse settings.
Davy et al., 2015; Wagner, Austin, and Von Korff, 1996; Wagner et al., 2001	Development of the Chronic Care Model, a heuristic model for organizing care for chronically ill patients; application and systematic review of its effectiveness.	The mismatch between the kind of support people with chronic conditions need and that which is available from health systems can be addressed by effective system changes, summarized in the evidence‐based Chronic Care Model.
Nolte and McKee, 2008; Armitage et al., 2009; Ham, 2010; Suter et al., 2009	Analysis of health systems’ responses to caring for people with chronic conditions, effectiveness and impact of health systems integration, and characteristics of (a) high‐performing chronic care systems and (b) successfully integrated health systems.	A systems perspective provides insight into (a) the features of systems that create fragmentation of care and shortfalls in appropriate responses to people with chronic conditions and (b) the actions required to integrate systems and hence to generate improved service delivery and population health.
Conceptual Models of Integrated Care (7 papers)
Fulop, Mowlem, and Edwards, 2005; Kodner and Kryiacou, 2000; Leutz, 1999; Singer et al., 2018; Valentijn et al., 2013	Synthesis of empirical work to define integrated care, extend conceptual understanding, and develop conceptual frameworks and explanatory models.	Comprehensive conceptual models can account for different typologies and degrees of integration, the components of integration, and the relationship between these components.
Kirst et al., 2017; Sheaff et al., 2018	Realist reviews/synthesis of processes that are associated with success of integrated care programs; evidence and assumptions about how new models of integrated care can change use of health care.	Realist approaches build theory about connections between outcomes, mechanisms, and context in successful integrated care programs.
Theoretical and Critical Analysis (9 papers)
Patient Trajectories
Allen, Griffiths, and Lyne, 2004; Nugus et al., 2010	Empirical studies from the United Kingdom and Australia of patients’ trajectories through complex service provision, drawing on theories of illness trajectories, game theory, and complex adaptive systems.	Patients’ trajectories are unpredictable, not random, and emerge from complex systems.
Recursive Nature of Structure/Agency
Embuldeniya et al, 2018; Williams and Sullivan, 2009	Empirical study of integrated payment mechanisms in Canada, and integrated health and social care in Wales, drawing on practice theory, Bourdieu, and habitus.	Integration was iteratively generated by the recursive interplay between structures of integrated care and individuals’ actions.
Social Organization of Work
Allen, 2014; Shaw et al., 2017	Empirical studies from the United Kingdom of the organization of work through integrated care pathways and patients’ transitions from hospital, drawing on boundary object theory and institutional logics.	The organization of work across and within organizations and institutions can be analyzed as a series of social processes or practices.
Critical Analysis
Dickinson et al., 2013; Hammond et al., 2017; Pickard, 2009	With a focus on English health policy, critically analyzing joint commissioning, and analyzing discourses of (1) place and (2) old age.	Integrated care strategies perform other work in addition to their ostensive aims, shaped by political and social contexts and power relations.

^aHow integrated care is understood to manifest and affect change.