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Can service integration work for universal health coverage? Evidence from around the globe

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Listed:
  • Lê, Gillian
  • Morgan, Rosemary
  • Bestall, Janine
  • Featherstone, Imogen
  • Veale, Thomas
  • Ensor, Tim

Abstract

Universal health coverage (UHC) is at the heart of the new 2030 Agenda for Sustainable Development. Health service integration is seen by World Health Organization as an essential requirement to achieve UHC. However, to date the debate on service integration has focused on perceived benefits rather than empirical impact. We conducted a global review in a systematic manner searching for empirical outcomes of service integration experiments in UHC countries and those on the path to UHC. Sixty-seven articles and reports were found. We grouped results into a unique integration typology with six categories – medical staff from different disciplines; patients and medical staff; care package for one medical condition; care package for two or more medical conditions; specialist stand-alone services with GP services; community locations. We showed that it is possible to integrate services in different human development contexts delivering positive outcomes for patients and clinicians without incurring additional costs. However, the improved outcomes shown were incremental rather than radical and suggest that integration is likely to enhance already well established systems rather than fundamentally changing the outcomes of care.

Suggested Citation

  • Lê, Gillian & Morgan, Rosemary & Bestall, Janine & Featherstone, Imogen & Veale, Thomas & Ensor, Tim, 2016. "Can service integration work for universal health coverage? Evidence from around the globe," Health Policy, Elsevier, vol. 120(4), pages 406-419.
  • Handle: RePEc:eee:hepoli:v:120:y:2016:i:4:p:406-419
    DOI: 10.1016/j.healthpol.2016.02.007
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    References listed on IDEAS

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    1. Ahmed, Haitham M. & Mitchell, Marc & Hedt, Bethany, 2010. "National implementation of Integrated Management of Childhood Illness (IMCI): Policy constraints and strategies," Health Policy, Elsevier, vol. 96(2), pages 128-133, July.
    2. Kruk, Margaret Elizabeth & Porignon, Denis & Rockers, Peter C. & Van Lerberghe, Wim, 2010. "The contribution of primary care to health and health systems in low- and middle-income countries: A critical review of major primary care initiatives," Social Science & Medicine, Elsevier, vol. 70(6), pages 904-911, March.
    3. Dean T. Jamison & Joel G. Breman & Anthony R. Measham & George Alleyne & Mariam Claeson & David B. Evans & Prabhat Jha & Ann Mills & Philip Musgrove, 2006. "Disease Control Priorities in Developing Countries, Second Edition," World Bank Publications - Books, The World Bank Group, number 7242, April.
    4. Rifat Atun & Thyra de Jongh & Federica V. Secci & Kelechi Ohiri & Olusoji Adeyi, 2009. "Clearing the Global Health Fog : A Systematic Review of the Evidence on Integration of Health Systems and Targeted Interventions," World Bank Publications - Books, The World Bank Group, number 5946, April.
    5. Akiko Maeda & Edson Araujo & Cheryl Cashin & Joseph Harris & Naoki Ikegami & Michael R. Reich, 2014. "Universal Health Coverage for Inclusive and Sustainable Development : A Synthesis of 11 Country Case Studies [Une couverture sanitaire universelle pour un développement durable inclusive : Une synt," World Bank Publications - Books, The World Bank Group, number 18867, April.
    6. Bernard Couttolenc & Michele Gragnolati & Magnus Lindelow, 2013. "Twenty Years of Health System Reform in Brazil : An Assessment of the Sistema Único de Saúde," World Bank Publications - Books, The World Bank Group, number 15801, April.
    7. United Nations UN, 2015. "Transforming our World: the 2030 Agenda for Sustainable Development," Working Papers id:7559, eSocialSciences.
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