Banfield Michelle, Jowsey Tanisha, Parkinson Anne, Douglas Kirsty A, Dawda Paresh
Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Rd, Acton, ACT 2601, Australia.
Centre for Medical and Health Sciences Education The University of Auckland, Auckland City Hospital, Building 599, Level 12, Auckland, 1023, New Zealand.
BMC Fam Pract. 2017 Jan 10;18(1):2. doi: 10.1186/s12875-016-0575-z.
The terms integration and integrated care describe the complex, patient-centred strategies to improve coordination of healthcare services. Frameworks exist to conceptualise these terms, but these have been developed from a professional viewpoint. The objective of this study was to explore consumers' and providers' concepts, expectations and experience of integrated care. A key focus was whether frameworks developed from a professional perspective are effective models to explore people's experiences.
A qualitative pilot study was undertaken at one Australian multidisciplinary primary health care centre. Semi-structured interviews were conducted with consumers (N = 19) and staff (N = 10). Data were analysed using a framework analysis approach.
Consumers' experience of integrated care tended to be implicit in their descriptions of primary healthcare experiences more broadly. Experiences related to the typologies involved clinical and functional integration, such as continuity of providers and the usefulness of shared information. Staff focused on clinical level integration, but also talked about a cultural shift that demonstrated normative, professional and functional integration.
Existing frameworks for integration have been heavily influenced by the provider and organisational perspectives. They are useful for conceptualising integration from a professional perspective, but are less relevant for consumers' experiences. Consumers of integrated primary health care may be more focussed on relational aspects of care and outcomes of care.
整合及整合式照护这两个术语描述了旨在改善医疗服务协调的复杂的、以患者为中心的策略。已有一些框架来对这些术语进行概念化，但这些框架是从专业视角开发的。本研究的目的是探究消费者和提供者对于整合式照护的概念、期望及体验。一个关键重点是从专业角度开发的框架是否是探索人们体验的有效模型。
在澳大利亚的一个多学科初级卫生保健中心开展了一项定性试点研究。对消费者（N = 19）和工作人员（N = 10）进行了半结构化访谈。使用框架分析方法对数据进行了分析。
消费者对整合式照护的体验在他们对更广泛的初级卫生保健体验的描述中往往是隐含的。与类型学相关的体验涉及临床和功能整合，例如提供者的连续性以及共享信息的有用性。工作人员关注临床层面的整合，但也谈到了一种体现规范、专业和功能整合的文化转变。
现有的整合框架受到提供者和组织视角的严重影响。它们对于从专业角度对整合进行概念化很有用，但与消费者的体验相关性较小。整合式初级卫生保健的消费者可能更关注照护的关系层面和照护结果。
