Noor Fadumo, Gulis Gabriel, Karlsson Leena Eklund
Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Campus Esbjerg, Esbjerg Ø, Denmark.
J Public Health Res. 2023 Jul 6;12(3):22799036231181210. doi: 10.1177/22799036231181210. eCollection 2023 Jul.
Many health care systems attempt to develop an integrated care approach that is a whole population health-oriented system. However, knowledge of strategies to support this effort are scarce and fragmented. The aim of the current paper is to investigate existing concepts of integrated care and their elements from a public health perspective and to propose an elaborated approach that could be applied to explore the public health orientation of integrated care.
We applied a scoping review approach. A literature search was conducted in Embase, Medline, CINAHL, Scopus and Web of Science for the period 2000-2020 yielding 16 studies for inclusion.
Across the papers, 14 frameworks were identified. Nine of these referred to the Chronic Care Model (CCM). Service delivery, person-centeredness, IT systems design and utilization and decision support were identified as the core elements of most of the included frameworks. The descriptions of these elements were mainly clinical-oriented focusing particularly on clinical care processes and treatment of diseases instead of wider determinants of population health.
A synthesized model is proposed that emphasizes the importance of mapping the unique needs and characteristics of the population it aims to serve, leans on the social determinants approach with a commitment to individual and community empowerment, health literacy and suggests reorienting services to meet the expressed needs of the population.
许多医疗保健系统试图发展一种综合护理方法，即一种以全人群健康为导向的系统。然而，支持这项工作的策略知识稀缺且零散。本文的目的是从公共卫生角度研究现有的综合护理概念及其要素，并提出一种详细的方法，可用于探索综合护理的公共卫生导向。
我们采用了范围综述方法。在Embase、Medline、CINAHL、Scopus和Web of Science数据库中对2000年至2020年期间的文献进行检索，共纳入16项研究。
在这些论文中，共识别出14个框架。其中9个参考了慢性病护理模型（CCM）。服务提供、以人为本、信息技术系统设计与应用以及决策支持被确定为大多数纳入框架的核心要素。这些要素的描述主要以临床为导向，特别关注临床护理过程和疾病治疗，而非人群健康的更广泛决定因素。
提出了一个综合模型，该模型强调了解其旨在服务人群的独特需求和特征的重要性，借鉴社会决定因素方法，致力于增强个人和社区权能、提高健康素养，并建议重新调整服务方向以满足人群表达的需求。
