McMaster University, Faculty of Health Sciences, Founder and Director, System-Linked Research Unit on Health and Social Service Utilization; Professor, School of Nursing, Department of Clinical Epidemiology and Biostatistics, Hamilton, Ontario, Canada.
Int J Integr Care. 2007 Dec 20;7:e51. doi: 10.5334/ijic.214.
Integration has been advanced as a strategy for the delivery of a number of human services that have traditionally been delivered by autonomous agencies with independent processes and funding sources. However, measurement of the dimensions of integration has been hampered by numerous factors, including a lack of definitional and conceptual clarity of integration, and the use of measurement tools with atheoretical foundations and limited psychometric testing. THEORY/METHODS: Based on a review of integration measurement approaches, a comprehensive approach to the measure of multiple dimensions of integrated human service networks was conceptualized. The combination of concepts was derived from existing theoretical, policy, and measurement approaches in order to establish the content validity and comprehensiveness of the proposed measure.
The dimensions of human service integration measures are: (1) Observed (current) and expected structural inputs, or the mix of agencies that comprise the network (e.g. extent, scope, depth, congruence within an agency, and reciprocity between agencies). (2) Functioning of the network both in terms of the quality of the network or partnership functioning and ingredients of the integration of the networks' working arrangements and range of human services provided. (3) Network outputs in terms of network capacity (e.g. what is accomplished, for how many and how quickly given the local demand) measured from dual perspectives of the agency and the family.
This newly developed measure unites multiple perspectives in a comprehensive approach to the measurement of integration of human service networks. Content validity has been established. Future work should focus on further refinement of this instrument through psychometric evaluation (e.g. construct validity) in diverse networks and relating these measures of network integration to client and system outcomes.
整合已被提出来作为一项战略，以提供一些传统上由具有独立流程和资金来源的自治机构提供的多项人类服务。然而，由于诸多因素的影响，包括整合的定义和概念不明确，以及使用理论基础薄弱且心理测量测试有限的测量工具，对整合维度的测量一直受到阻碍。
理论/方法：基于对整合测量方法的回顾，我们构想了一种综合方法来衡量多种维度的综合人类服务网络。这些概念的组合来自于现有的理论、政策和测量方法，以确立所提出的测量方法的内容有效性和全面性。
人类服务整合措施的维度是：（1）观察到的（当前）和预期的结构投入，或构成网络的机构组合（例如，范围、深度、一致性在一个机构内，以及机构之间的互惠性）。（2）网络的运作，既包括网络或伙伴关系运作的质量，也包括网络工作安排和提供的各种人类服务整合的要素。（3）从机构和家庭的双重角度来衡量网络能力（例如，给定当地需求，完成了多少、为多少人完成以及完成的速度）的网络产出。
这个新开发的测量方法将多种观点结合在一个综合方法中，用于衡量人类服务网络的整合。内容有效性已经确立。未来的工作应侧重于通过在不同网络中进行心理测量评估（例如，构念效度）进一步完善该工具，并将这些网络整合措施与客户和系统结果联系起来。
