de Matos Ricardo Correia, do Nascimento Generosa, Campos Fernandes Adalberto, Matos Cristiano
Department of Psychiatry and Mental Health, Unidade Local de Saúde da Região de Aveiro (ULSRA), EPE, 3810-164 Aveiro, Portugal.
Ordem dos Enfermeiros, 1600-848 Lisboa, Portugal.
J Mark Access Health Policy. 2025 Jun 5;13(2):28. doi: 10.3390/jmahp13020028. eCollection 2025 Jun.
The integration of health and social care is increasingly recognized as essential to address population ageing, the rise in chronic diseases, and persistent health inequities. Across Europe, diverse models have been developed to improve service coordination, resource efficiency, and person-centered care. This paper aims to explore international experiences in integrating health and social care, identify common strategies and challenges, and provide insights to inform policy development in countries where integration remains incipient, with a focus on Portugal. A qualitative comparative approach was employed. A systematic literature review was conducted across PUBMED, MEDLINE, and Google Scholar, including peer-reviewed articles, policy reports, and government documents. Thematic analysis was used to identify integration models, enablers, and barriers across different countries. Different models reveal that joint governance, pooled funding, strong community involvement, and digital innovation are key enablers of integration. However, common challenges persist, including fragmented governance, inconsistent implementation, and financial sustainability. In Portugal, structural separation between the health and social sectors continues to limit strategic alignment. Successful integration depends on political commitment, shared vision, and active stakeholder collaboration. European models offer adaptable lessons for Portugal and similar systems, especially regarding intersectoral coordination and preventive care. Integrating health and social care is vital for building resilient, equitable systems. Portugal must adopt a cohesive national strategy; strengthen local implementation; and embrace person-centered, sustainable solutions to ensure long-term impact. Integrating the health and social sectors is indispensable in navigating the ever-evolving healthcare landscape and promoting holistic well-being.
健康与社会护理的整合日益被视为应对人口老龄化、慢性病增加以及持续存在的健康不平等问题的关键。在欧洲，已经开发出多种模式来改善服务协调、资源效率和以患者为中心的护理。本文旨在探讨健康与社会护理整合的国际经验，确定共同的策略和挑战，并为整合仍处于起步阶段的国家（以葡萄牙为重点）的政策制定提供见解。采用了定性比较方法。在PubMed、MEDLINE和谷歌学术上进行了系统的文献综述，包括同行评审文章、政策报告和政府文件。采用主题分析来确定不同国家的整合模式、促进因素和障碍。不同模式表明，联合治理、集中资金、强大的社区参与和数字创新是整合的关键促进因素。然而，常见的挑战依然存在，包括治理碎片化、实施不一致和财政可持续性。在葡萄牙，卫生和社会部门之间的结构分离继续限制战略一致性。成功的整合取决于政治承诺、共同愿景和利益相关者的积极合作。欧洲模式为葡萄牙和类似体系提供了可借鉴的经验教训，特别是在部门间协调和预防保健方面。整合健康与社会护理对于建立有韧性、公平的体系至关重要。葡萄牙必须采取统一的国家战略；加强地方实施；并采用以患者为中心的可持续解决方案，以确保长期影响。在应对不断演变的医疗保健格局和促进整体福祉方面，整合卫生和社会部门是不可或缺的。
