School of Public Policy, University of Calgary, Calgary, Alberta, Canada.
Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
BMJ Open. 2018 Nov 15;8(11):e021374. doi: 10.1136/bmjopen-2017-021374.
Integrated care is viewed widely as a potential solution to some of the major challenges faced by health and social care systems, such as those posed by service duplication, fragmentation and poor care coordination, and associated impacts on the quality and cost of services. Fragmented models of allocating funds to and across sectors, programmes and providers are frequently cited as a major barrier to integration and countries have experimented with different models of allocating funds to enhance care coordination among service providers and to reduce ineffective care and avoid costly adverse events. This scoping review aims to assess published international experiences of different models of allocating funds to facilitate integration and the evidence on their impacts.
We will adopt a scoping review methodology due to the potentially vast and multidisciplinary nature of the literature on different models of allocating funds in health and social care systems, as well as the scarcity of existing knowledge syntheses. The framework developed by Arksey and O'Malley will be followed that entails six steps: (1) identifying the research question(s), (2) searching for relevant studies, (3) selecting studies, (4) charting the data, (5) collating, summarising and reporting the results and (6) and conducting consultation exercises. These steps will be conducted iteratively and reflexively, making adjustments and repetitions when appropriate to make sure the literature has been covered as comprehensively as possible. To ensure comprehensiveness of our literature review, we also search a wide range of sources.
An integrated knowledge translation strategy will be pursued by engaging our knowledge users through all stages of the review. We will organise two workshops or policy roundtables/policy dialogues in Alberta and British Columbia with participation of diverse knowledge users to discuss and interpret the findings of our review and to draw out policy opportunities and lessons that can be applied to the context of these two provinces.
综合护理被广泛认为是解决医疗和社会保健系统面临的一些主要挑战的潜在方法,例如服务重复、碎片化和护理协调不善,以及对服务质量和成本的影响。分配资金给部门、项目和提供者的碎片化模式经常被认为是整合的主要障碍,各国已经尝试了不同的资金分配模式,以加强服务提供者之间的护理协调,减少无效护理,避免昂贵的不良事件。本范围界定审查旨在评估不同资金分配模式促进整合的国际经验和证据。
由于医疗和社会保健系统中不同资金分配模式的文献具有潜在的广泛和多学科性质,以及现有知识综合的稀缺性,我们将采用范围界定审查方法。阿特塞和奥马利提出的框架将遵循以下六个步骤:(1)确定研究问题;(2)搜索相关研究;(3)选择研究;(4)绘制数据;(5)整理、总结和报告结果;(6)进行咨询活动。这些步骤将迭代和反思性地进行,根据需要进行调整和重复,以确保文献尽可能全面地涵盖。为确保文献综述的全面性,我们还搜索了广泛的来源。
我们将通过在审查的所有阶段与知识用户互动,实施综合知识转化策略。我们将在艾伯塔省和不列颠哥伦比亚省举办两次研讨会或政策圆桌会议/政策对话,让不同的知识用户参与,讨论和解释我们的审查结果,并提出可以应用于这两个省背景的政策机会和经验教训。