Impact of chronic disease integration strategies on healthcare outcomes and costs in Canada: A scoping review

There has been a growing body of evidence suggesting that chronic care integration strategies can improve healthcare outcomes and decrease costs. In fact, according to the World Health Organization (2002), there is an opportunity to improve health care for chronic conditions and to curtail the growth in healthcare expenditures through integration and coordination. The purpose of this scoping review is to evaluate the impact of chronic disease integration strategies on healthcare outcomes and costs in Canada. For the purpose of this study, the words chronic disease, healthcare costs, integration and Canada were searched for in five peer-reviewed databases. The inclusion criteria included papers published from 2006 to 2020 in English. The results showed 37 papers that met the inclusion criteria, 51 per cent of which were published from 2006 to 2015 and 49 per cent from 2016 to 2020. The papers were critically appraised for quality (5 per cent strong, 11 per cent moderate, 16 per cent weak and 68 per cent not applicable); 35 per cent, however, were protocols and did not provide evidence. Only two papers demonstrated improved healthcare outcomes and decreased utilisation. Although there was insufficient evidence, this review contributes by highlighting the need to further implement chronic disease integration strategies to demonstrate healthcare outcomes and costs. This review identifies research gaps and provides directions for researchers and implications for healthcare managers and policymakers.